We surveyed 49 practicing nephrologists in North Carolina and determined their preferences among eight currently available end-stage renal disease treatment modalities using the method of paired comparisons. We also obtained background information about the nephrologists and their practices and data from the North Carolina Network about actual assignment of patients to treatment during the year prior to the survey. There was a striking congruence (p < 0.001) of treatment preferences among the nephrologists. Although transplantation modalities were clearly preferred over both home and facility dialysis, and home hemodialysis was the preferred dialysis modality, relatively few patients received transplants or were trained for home hemodialysis. The elements contributing to treatment selection other than physician preference are discussed.
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