TY - JOUR
T1 - Selection of ESRD Treatment
T2 - An International Study
AU - Mattern, W. D.
AU - McGaghie, W. C.
AU - Rigby, R. J.
AU - Nissenson, A. R.
AU - Dunham, C. B.
AU - Khayrallah, M. A.
N1 - Funding Information:
From the University of North Carolina, Chapel Hill; University of California, Los Angeles; and Princess Alexandra Hospital, Brisbane, Australia. Supported by a grant from Baxter Health Care Corporation, Deerfield, IL. Address reprint requests to William D. Mattern, MD, Professor of Medicine, UNC School of Medicine, CB #7005, 3034 Old Clinic Bldg, Chapel Hill, NC 27599. © 1989 by the National Kidney Foundation, Inc. 0272-6386/89/1306-0002$3.00/0
PY - 1989
Y1 - 1989
N2 - 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.
AB - 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.
KW - ESRD treatment selection
KW - diabetes mellitus
KW - dialysis
KW - kidney transplantation
KW - peritoneal dialysis
KW - the elderly
UR - http://www.scopus.com/inward/record.url?scp=0024392573&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0024392573&partnerID=8YFLogxK
U2 - 10.1016/S0272-6386(89)80002-2
DO - 10.1016/S0272-6386(89)80002-2
M3 - Article
C2 - 2658559
AN - SCOPUS:0024392573
VL - 13
SP - 457
EP - 464
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 6
ER -