Selection of ESRD Treatment: An International Study

W. D. Mattern, W. C. McGaghie, R. J. Rigby, A. R. Nissenson, C. B. Dunham, M. A. Khayrallah

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Using the method of paired comparisons, we surveyed nephrologists in three different socioeconomic regions, North Carolina, Southern California, and Australia-New Zealand, to determine their preferences among the major end-stage renal disease (ESRD) treatment modalities. For comparison, we also determined how patients were assigned to the treatment modalities, based on registry data in the regions. Preferences were determined for six standard ESRD treatment modalities—living related donor (LRD), four-antigen match, LRD two-antigen match, and cadaver (CAD) transplantation; and home peritoneal dialysis (HPD), home hemodialysis (HHD), and facility hemodialysis (FHD)—and for three categories of patients—patients with diabetes, patients over age 60, and patients in general. There was overall agreement in the ranking of treatments by the nephrologists from all three regions for each of the three patient categories; however, significant differences were noted between regions in preferences for certain modalities. Comparison within and between regions revealed striking disparities between preferences and practice. Analysis of these findings provides important insights into the process of ESRD treatment selection and identifies issues that merit further consideration.

Original languageEnglish (US)
Pages (from-to)457-464
Number of pages8
JournalAmerican Journal of Kidney Diseases
Issue number6
StatePublished - 1989


  • ESRD treatment selection
  • diabetes mellitus
  • dialysis
  • kidney transplantation
  • peritoneal dialysis
  • the elderly

ASJC Scopus subject areas

  • Nephrology


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