Knowledge, attitude, and practice of nephrologists on the decision for renal replacement therapy

This study aimed to investigate the Knowledge, Attitude, and Practice (KAP) of nephrologists on the decision of renal replacement therapy (RRT), including peritoneal dialysis, hemodialysis, and kidney transplantation.

This multicenter cross-sectional study was conducted on qualified nephrologists who volunteered to participate between July and August 2022 by using a self-administered questionnaire.

Among 327 nephrologists, the total knowledge, attitude, and practice scores were 12.03 ± 2.11/16, 58.39 ± 6.62/75, and 27.15 ± 2.74/30, respectively. Multivariate logistic regression analysis showed that the attitude score (peritoneal dialysis: OR = 1.19, 95%CI: 1.13-1.25, P < 0.001; hemodialysis: OR = 1.14, 95%CI: 1.09-1.19, P < 0.001; kidney transplantation: OR = 1.12, 95%CI: 1.07-1.16, P < 0.001), 41-50 years of age (peritoneal dialysis: OR = 0.45, 95%CI: 0.21-0,98, P = 0.045; hemodialysis: OR = 0.27, 95%CI: 0.12-0.60, P = 0.001; kidney transplantation: OR = 0.45, 95%CI:0.20-0.97, P = 0.042), and > 50 years of age (peritoneal dialysis: OR = 0.27, 95%CI: 0.08-0.84, P = 0.024; hemodialysis: OR = 0.45, 95%CI: 0.20-0.97, P = 0.042; kidney transplantation: OR = 0.24, 95%CI: 0.08-0.77, P = 0.016) were independently associated with the consideration score of peritoneal dialysis, hemodialysis, and kidney transplantation.

Better attitudes may lead to more consideration by nephrologists when choosing between peritoneal dialysis, hemodialysis, and kidney transplantation and relatively less consideration by senior physicians when making decisions; in addition, having good knowledge and good attitudes may lead to better practice.