Abstract
Background: Despite excellent clinical outcome (gross annual mortality 6%) remains the proportion of patients treated by peritoneal dialysis (PD) in the Czech Republic (CZ) very low (7-8%). With this in mind we organized an opinion poll among nephrology professional trying to detect decision making paradigmas during the choice of dialysis modality.
Methods: 34 physicians and 24 nurses from dialysis units, neprology and kidney transplant(Tx)out-patients units were asked about the underlying diagnosis of their clients, their attitude to hemodialysis (HD), PD and Tx, time spent with individual predialysis education etc. Results: Out of the physicians addressed, 65% worked in an out patient /dialysis unit affiliated with a hospital, 21% in an independent out patient unit, 12% in a health center a 3% in a hospital.
Patients with CKD stage 4, on HD and PD account for 11% of the klientele the participating nephrologists. PD with subsequent Tx and/or preemptive Tx are cosidered significantly more suitable than HD with eventul subsequent Tx.
From the point of view of nephrology staff emphasis is put on the efficiacy and long-term practical experience (favored HD). Nephrology staff does not perceive much difference between PD and HD with the exception of suitability for complicated patients and long-term experience in the unit (favored HD).
For patients with an active life style, excellent compliance, of younger age, Tx candidate is favored PD. The average time of individual predialysis education is 45 minutes.
Conclusion: Low PD penetration in CZ might be explained by the requirement to include "ideal" patients only despite the fact that even patients with co-morbidity, dependent on a helper, of advanced age, not eligible as Tx candidates might benefit from PD as well. Further educational activities and raising of public awarness should bu focused this direction.