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Informed Dialysis Modality Selection Among Veterans With Advanced CKD: A Community-Level Needs Assessment
- Source :
- Kidney Medicine, Vol 6, Iss 6, Pp 100832- (2024)
- Publication Year :
- 2024
- Publisher :
- Elsevier, 2024.
-
Abstract
- Rationale & Objective: The Advancing Americans Kidney Health Executive order has directed substantial increases in home dialysis use for incident kidney replacement therapy (KRT). Clinical guidelines recommend patients’ self-selection of KRT modality through a shared decision-making process, which, at the minimum, requires predialysis nephrology care and KRT-directed comprehensive prekidney failure patient education (CoPE). The current state of these essential services among Americans with advanced (stages 4 and 5) chronic kidney disease (CKD) and their informed preferences for home dialysis are unknown. Study Design: We conducted a community-based, cross-sectional, observational cohort study across a large regional Veteran Healthcare System from October 1, 2020, to September 30, 2021. Setting & Participants: Of the 928 Veterans with advanced CKD, 287 (30.9%) were invited for needs assessment evaluations. Of the 218 (76% of invited cohort) responding, 178 (81.6%) were receiving nephrology care, with approximately half of those (43.6%) receiving such care from non-Veterans Affairs providers. Outcomes: The study was targeted to assess the prevalent state of ongoing nephrology care and KRT-directed pre-kidney failure education among Veterans with advanced CKD. The secondary outcome included evaluation of dialysis decision-making state among Veterans with advanced CKD. Analytical Approach: Veterans with advanced CKD with 2 sustained estimated glomerular filtration rates
Details
- Language :
- English
- ISSN :
- 25900595
- Volume :
- 6
- Issue :
- 6
- Database :
- Directory of Open Access Journals
- Journal :
- Kidney Medicine
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.fd62ec096a624a8881250f37a99067a8
- Document Type :
- article
- Full Text :
- https://doi.org/10.1016/j.xkme.2024.100832