Abstract
Aim: The PREPARE study (PRE-dialysis healthcare in PAtients initiating Renal rEplacement therapy and its consequences) evaluates the quality of pre-dialysis healthcare in patients commencing dialysis treatment in the Czech Republic. Methods: 48% of Czech dialysis centers participating in this prospective multicenter observational study provided data on all consecutive patients starting renal replacement therapy during 24 weeks. Results: 68% out of 303 patients had nephrological pre-dialysis care lasting >6 months (57% diabetics). Peritoneal dialysis (PD) was chosen by
11.2%.
23.6% of patients were receiving erythropoiesis-stimulating agents while the mean hemoglobin level was
98.3 +/-
15.6 g/l.
36.1% of patients were taking phosphate binders while serum phosphates reached
1.90 +/-
0.61 mmol/l.
64.4% of patients had a functional arteriovenous fistula or PD catheter.
91.8% of the patients felt they were well informed about hemodialysis and
51.6% about PD. Physicians reported poor compliance of patients in
15.1% of cases, while the patients evaluated their own compliance as
9.4%. Conclusions: To conclude: (1) better pre-dialysis care and information are needed; (2) higher awareness on PD might increase its low popularity; (3) particular attention should be paid to diabetics due to their higher morbidity, a lower proportion considered for transplantation and a lower proportion referred to nephrologists by diabetologists, and (4) preemptive transplantation should be considered more often.