Kidney Week

Abstract: FR-PO1062

The Nephrologist as a Potential Buffering Factor in Patient Loyalty Among Individuals Receiving Long-Term Hemodialysis

Session Information

• Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Torres, Liv, Pontificia Universidad Catolica Madre y Maestra Facultad de Ciencias de la Salud, Santiago de los Caballeros, Dominican Republic

Liv Torres, MD

• Amaro, Moisés, Hospital Metropolitano de Santiago, Santiago de los Caballeros, Dominican Republic

Moisés Amaro, MD

• Pichardo Arias, Angie A., Pontificia Universidad Catolica Madre y Maestra Facultad de Ciencias de la Salud, Santiago de los Caballeros, Dominican Republic

Angie A. Pichardo Arias, MD

• Llopis, Ehiby, Pontificia Universidad Catolica Madre y Maestra Facultad de Ciencias de la Salud, Santiago de los Caballeros, Dominican Republic

Ehiby Llopis, MD

• Gutierrez, Anthony Jose, Hospital Clinic de Barcelona, Barcelona, Spain

Anthony Jose Gutierrez, DrMed

• López Zabala, Luis Ariel, Pontificia Universidad Catolica Madre y Maestra Facultad de Ciencias de la Salud, Santiago de los Caballeros, Dominican Republic

Luis Ariel López Zabala, MBA

• Dina-Batlle, Eliana, Hospital Metropolitano de Santiago, Santiago de los Caballeros, Dominican Republic

Eliana Dina-Batlle, MD, MS, FASN

Background

Patient loyalty in hemodialysis is influenced by both institutional experience and the physician-patient relationship. However, the extent to which satisfaction with the nephrologist may mitigate the impact of suboptimal institutional perceptions remains poorly explored.

Methods

A cross-sectional study was conducted among adult patients undergoing chronic hemodialysis at a renal center in Santiago de los Caballeros, Dominican Republic, from April 2025 to April 2026. Our objective was to evaluate the association between satisfaction with the nephrologist and patient loyalty, and to explore the potential buffering role of the nephrologist in patients with non-optimal institutional satisfaction. Sociodemographic data and reported measures were collected: Visit-Specific Satisfaction Instrument (VSQ-9), Service Quality in Hospital (SERVQHOS), and Net Promoter Score (NPS). Spearman correlations assessed associations with loyalty. An exploratory quadrant analysis examined loyalty patterns according to nephrologist and institutional satisfaction levels.

Results

93 patients were included, with a mean age of 51.7 ± 15.1 years. 66.7% were male. Mean VSQ-9, SERVQHOS, and NPS scores were 81.5 ± 16.6, 3.80 ± 0.71, and 9.13 ± 1.22, respectively. 73.1% of patients were promoters. In the exploratory quadrant analysis, patients with high satisfaction with the nephrologist maintained favorable recommendation patterns even when institutional satisfaction was non-optimal, suggesting a potential buffering effect of the physician-patient relationship on patient loyalty.

Conclusion

Satisfaction with the nephrologist was significantly associated with patient loyalty in chronic hemodialysis. High physician satisfaction appeared to partially buffer the impact of non-optimal institutional perceptions on patient recommendation patterns, supporting a potential mediating role of the nephrologist in the overall patient experience.

A) High VSQ-9 preserved high NPS despite lower SERVQHOS, suggesting a protective physician effect. B) VSQ-9 correlated with NPS (R=0.22, p=0.035), supporting its association with loyalty in the study.