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Customized versus conventional video counseling for peritoneal dialysis decision-making in patients with stage 5 chronic kidney disease under a PD-first policy: a randomized controlled study

Kidney Research and Clinical Practice 2020년 39권 4호 p.451 ~ 459
Parapiboon Watanyu, Pitsawong Wannapat, Wongluechai Laddaporn, Thammavaranucupt Kanin, Raegasint Lalana,
소속 상세정보
 ( Parapiboon Watanyu ) - Maharat Nakhon Ratchasima Hospital Department of Medicine
 ( Pitsawong Wannapat ) - Maharat Nakhon Ratchasima Hospital Department of Medicine
 ( Wongluechai Laddaporn ) - Maharat Nakhon Ratchasima Hospital Department of Medicine
 ( Thammavaranucupt Kanin ) - Maharat Nakhon Ratchasima Hospital Department of Medicine
 ( Raegasint Lalana ) - Maharat Nakhon Ratchasima Hospital Department of Medicine

Abstract


Background: Indecision regarding the start of peritoneal dialysis (PD) is a challenging problem in chronic kidney disease (CKD) stage 5 patients who receive conventional video counseling. This study aimed to evaluate the effect of video counseling customized to the local context versus conventional video counseling on PD decision-making in CKD stage 5 patients under PD-first policy.

Methods: We enrolled 120 patients with stage 5 CKD in Thailand who initiate PD between May 2016 to January 2017 in a randomized, open-label, controlled study. Patients were randomized to either a customized or conventional video counseling group. The primary outcome was PD acceptance rate with complete PD catheter insertion on schedule. The secondary outcomes were change in patient knowledge and confidence in PD and reasons for indecision PD.

Results: We analyzed 120 patients (customized, n = 60 vs. conventional, n = 60). The two groups were similar for age (55 vs. 56 years), blood urea nitrogen (89 vs. 86 mg/dL), creatinine (10.37 vs. 11.29 mg/dL), and eGFR (4.7 vs. 5.6 mL/min/1.73 m2). The PD acceptance rate along with PD catheter insertion on schedule in the customized video counseling group was not significantly different from that in the conventional video counseling group (66.6% vs. 63.3%, relative risk: 0.97, 95% confidence interval: 0.73 to 1.29; P = 0.86). Patient knowledge of and confidence in PD increased after counseling, but the difference was not significant.

Conclusion: Among stage 5 CKD patients, counseling content customized to a local context did not differ in a rate of acceptance for beginning PD with PD catheter insertion on schedule compared with conventional video counseling.

키워드

Counselling; Peritoneal dialysis; Peritoneal dialysis-first policy; Randomized controlled trial

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