Abstract
BackgroundAlthough most patients are suitable for both hemodialysis (HD) and peritoneal dialysis (PD), there seem to be differences in the outlook of patients who choose one modality over the other. There is currently limited literature about the impact of patients’ personal attitudes on the decision for PD or HD. In this study, we tried to find out whether there were differences between patients who were on HD and PD in their desire for control and responsibility for their treatment.MethodsThe data were drawn from a nationwide postal survey of 630 HD and PD patients. Patients’ desire for control was measured by scores on the internal locus of control (ILOC) scale. Patients were also asked how important taking responsibility for their dialysis had been for their treatment decision (ITR). Two multivariate logistic regression models, both adjusted for age, were applied to investigate whether there were differences between HD and PD patients in ILOC and ITR. Having one generic measure (ILOC) and one tailored to the dialysis context (ITR) gave the opportunity to investigate if it is a generic personality trait or rather a specific attitude that affects choice of dialysis modality.ResultsPD patients were younger and showed higher ILOC and ITR values. Multivariate logistic regression models adjusted for age confirmed the significant influence of ILOC and ITR on the uptake of PD. The odds ratios for being in the PD group were 1.53 for ILOC (p = 0.030; 95% CI 1.04–2.25), 1.49 for ITR (p = 0.019; 95% CI 1.07–2.07), and 0.95 (p = 0.000; 95% CI 0.94–0.97) for age in both models.ConclusionsOur analysis shows the impact of personal attitudes on the uptake of PD. Participants who generally want to keep control of their lives and take responsibility for their dialysis treatment tended to choose PD. As PD is a home dialysis treatment that requires patients to participate and contribute, it is beneficial if patients’ personalities support the treatment procedure. Having two completely different treatment options that suit to different personalities gives us the opportunity to consider the relationship between personal attitudes and choice of dialysis modality.Trial registrationThe MAU-PD study is registered at the German Clinical Trials Register.DRKS-ID: DRKS00012555.Date of Registration in DRKS: 2018/01/04.
Highlights
Most patients are suitable for both hemodialysis (HD) and peritoneal dialysis (PD), there seem to be differences in the outlook of patients who choose one modality over the other
90% (n = 565) started with in-center HD and 10% (n = 65) started with PD (CAPD, CCPD). Of those patients who started with PD, 37 (57%) later. Analysis This analysis aims to investigate the difference between in-center HD patients and PD patients (CAPD or CCPD)
Focusing on the role of personal attitudes in decision-making for PD, we categorized participants as PD patients who had initially decided for PD and later changed from PD to HD
Summary
Most patients are suitable for both hemodialysis (HD) and peritoneal dialysis (PD), there seem to be differences in the outlook of patients who choose one modality over the other. The compulsory statutory health insurance (SHI) in Germany covers about 90% of the population [7]. This SHI reimburses both, in-center and home-based dialysis treatment options as well as the transport to the ambulatory dialysis center [8]. Looking at patient-related characteristics, the international literature shows, that due to only a few absolute contraindications against PD, most ESRD patients are eligible for both modalities [10, 11]. Other patient-related factors, like personality traits or attitudes, and their role in the context of dialysis modality choice have hardly been investigated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
