Abstract: TH-PO982

Impacts of Options Education on Modality Choice in Incident ESRD Patients

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Jiao, Yue, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Lynch, Rob, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

Dialysis education programs that teach chronic kidney disease (CKD) patients about their renal replacement therapy (RRT) options may help patients to make informed decisions. The impact of educational programs on kidney modality choice is unknown. We analyzed the impacts of an options educational program on incident modality choice for hemodialysis (HD), peritoneal dialysis (PD), or transplant in patients who progressed to ESRD.

Methods

For this analysis, we collected data from Fresenius Kidney Care (FKC) patients who progressed to ESRD and started RRT between 2009 and 2016. Patients were categorized into groups depending on whether they received options education and if they started dialysis as outpatient or inpatient. We determined the annual percentage of ESRD patients who initiated RRT by modality choice (HD, PD, or transplant) in the first 120 days of RRT.

Results

A total of 300,818 patients who progressed to ESRD and initiated a RRT were included in the study; 68,721 patients received options education. In 2016, education prior starting RRT was associated with more patients (1 percentage point) receiving a transplant in the first 120 days of RRT, as compared to those without options education. Concurrently, in patients who received options education and started with outpatient dialysis for RRT, there were 16 percentage points more who utilized PD and 17 percentage points less treated by HD when compared to patients without options education. In patients who received options education and started dialysis as an inpatient in 2016, there were 3 percentage points more who were treated with PD and 2 percentage points less treated by HD when compared to patients without options education. Similar findings were observed in during every year in the study period.

Conclusion

These findings suggest that options education prior starting RRT may lead to a higher proportion of patients choosing a transplant or home dialysis when progressing to ESRD. Further analysis are needed to confirm these findings.

Funding

  • Commercial Support