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Patient Perspectives on Renal Replacement Therapy Modality Choice: A Multicenter Questionnaire Study on Bioethical
Michael S Balzer1, Christian Clajus2, Gabriele Eden3
1Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany balzer.michael@mh-hannover.de.
Patients on peritoneal dialysis (PD) feel more autonomous than those on hemodialysis (HD), despite being more critical of their treatment. Understanding these patient perspectives on renal replacement therapy (RRT) can help doctors guide choices.
Area of Science:
- Nephrology
- Bioethics
- Patient-centered care
Background:
- Peritoneal dialysis (PD) use is low in Germany compared to hemodialysis (HD).
- Patient perspectives on renal replacement therapy (RRT) choice are increasingly important.
- Bioethical dimensions of RRT choice have not been previously analyzed.
Purpose of the Study:
- To analyze differences in patient perspectives on PD versus HD regarding bioethical dimensions.
- To identify factors influencing RRT modality choice.
- To help nephrologists identify suitable PD candidates.
Main Methods:
- Multicenter questionnaire study with 121 stable RRT outpatients.
- Survey assessed bioethical dimensions: autonomy, beneficence, non-maleficence, justice, and trust.
- Used ranking and Likert scale items for data collection.
Main Results:
- Many patients felt excluded from RRT choice.
- PD patients were more critical of RRT, used diverse information sources, and reported more dissatisfaction.
- PD patients experienced less autonomy impairment regarding body integrity and dialysis.
Conclusions:
- PD patients exhibit greater scrutiny and feel more autonomous than HD patients.
- Patient empowerment and autonomy are key differences in PD versus HD perspectives.
- Insights can aid nephrologists in facilitating RRT modality selection.
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