The Impact of Predialysis Patient Education Counseling on Relative Frequencies of Renal Replacement Modalities

Naveed Mirza; Khalid A Sheikh; Saad Muzaffar; Noureen Chaudary; Dildar Ahmed; Ishtiaque Alam

doi:10.7759/cureus.10834

The Impact of Predialysis Patient Education Counseling on Relative Frequencies of Renal Replacement Modalities

Cureus. 2020 Oct 7;12(10):e10834. doi: 10.7759/cureus.10834.

Authors

Naveed Mirza¹, Khalid A Sheikh², Saad Muzaffar¹, Noureen Chaudary³, Dildar Ahmed¹, Ishtiaque Alam¹

Affiliations

¹ Nephrology, Armed Forces Hospital Southern Region, Khamis Mushait, Khamis Mushait, SAU.
² Neonatology, Armed Forces Hospital Southern Region, Khamis Mushait, Khamis Mushait, SAU.
³ Nephrology, Rawalpindi Medical University, Rawalpindi, PAK.

Abstract

Background and objective The predialysis education program (PDEP) is an integral part of the management of patients with end-stage renal disease (ESRD). Hence, the aim of this study was to assess the distribution of renal replacement therapy (RRT) among patients with ESRD who received PDEP counseling at a single tertiary care center in Khamis Mushait, Kingdom of Saudi Arabia (KSA). Methodology In this study, we included 177 patients with ESRD who received a series of structured PDEP counseling sessions between March 2018 and February 2019 at the Armed Forces Hospital, Southern Region, Khamis Mushait, KSA. All patients were offered available RRT options, which included hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), or renal transplantation. Patients' opted RRT modality was recorded and managed as per the international guidelines and institutional protocols. Results Out of 177 patients, 58.8% (104) were males, with a mean age of 59 ± 13.7 years. The most common comorbid condition as the primary diagnosis was diabetic nephropathy in 49.7% (88), followed by hypertension in 30.5% (54), bilateral small kidney in 15.3% (27), and renal stone in 5.1% (nine) of the patients. Among the available RRTs, 51.4% (91) chose HD, 5.1% (nine) decided on CAPD, four patients (2.3%) opted for renal transplantation, while the remaining 41.2% (73) had yet to choose one, out of which 83.6% (61/73) had stage-IV chronic kidney disease (CKD) while the remaining 16.4% (12/73) had stage-V CKD. Conclusions In conclusion, a series of structured PDEP sessions for the patients progressing to ESRD can facilitate their selection of RRT. In a resource-limited setting, such as ours, where the number of patients who seek treatment for ESRD is rising, PDEP can provide patients with adequate information and knowledge to equip them with the ability regarding the selection of a self-care RRT modality.

Keywords: chronic kidney disease; end-stage renal disease; hemodialysis; pre-dialysis education program; renal replacement therapy.