Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients

Figures & data

Figure 1 UPS-EP tools (Swedish version).

Abbreviations: UPS, unplanned dialysis start; EP, educational program.

Figure 2 Regression models for the factors influencing the three key steps of USP-EP.

Abbreviations: UPS, unplanned dialysis start; EP, educational program.

Table 1 Logistic regression analysis evaluating the predictors of receiving education in 270 UPS patients

Variables	Odds ratio (95% CI)	P-value
Age, ≥69 years	0.40 (0.20–0.80)	0.01
Gender, male versus female	0.73 (0.37–1.45)	0.37
Admission, inpatients versus outpatients	0.59 (0.27–1.31)	0.20
Diabetes, presence versus absence	0.65 (0.33–1.28)	0.21
Time between first referral to nephrologists and first dialysis, the same day versus later	0.63 (0.28–1.42)	0.26
Initial dialysis modality, PD versus HD	4.81 (1.85–12.50)	0.001
Congestive heart failure	0.71 (0.34–1.49)	0.37
Country, DE + FR + AU versus the UK + SE + DK	0.38 (0.18–0.82)	0.01

Notes: Pseudo-r²=0.12. Significant values are marked in bold (P<0.05).

Abbreviations: AU, Austria; CI, confidence interval; DE, Germany; DK, Denmark; FR, France; HD, hemodialysis; PD, peritoneal dialysis; SE, Sweden; UPS, unplanned dialysis start.

Table 2 Logistic regression analysis evaluating the predictors of making the choice on dialysis modality after receiving education in 214 UPS patients

Variables	Odds ratio (95% CI)	P-value
Age, ≥69 years	0.64 (0.37–1.11)	0.11
Gender, male versus female	1.70 (0.97–2.98)	0.07
Diabetes, presence versus absence	0.94 (0.53–1.64)	0.81
Initial dialysis modality, PD versus HD	6.33 (2.89–13.87)	<0.001
Country, DE + FR + AU versus the UK + SE + DK	0.50 (0.28–0.87)	0.02

Notes: Pseudo-r²=0.12. Significant values are marked in bold (P<0.05).

Abbreviations: AU, Austria; CI, confidence interval; DE, Germany; DK, Denmark; FR, France; HD, hemodialysis; PD, peritoneal dialysis; SE, Sweden; UPS, unplanned dialysis start.

Table 3 Logistic regression analysis evaluating the predictors of receiving dialysis modality according to patient preferred choice (n=159) versus not receiving preferred dialysis modality according to patient choice (n=18) following completion of UPS-EP

Variables	Odds ratio (95% CI)	P-value
Age, ≥67 years	0.98 (0.32–2.97)	0.95
Gender, male versus female	0.96 (0.28–3.24)	0.95
Diabetes, presence versus absence	0.84 (0.28–2.51)	0.76
Myocardial infarction	0.15 (0.05–0.48)	0.001
Initial dialysis modality, PD versus HD	3.66 (0.97–13.88)	0.06

Notes: Pseudo-r²=0.07. Significant values are marked in bold (P<0.05).

Abbreviations: CI, confidence interval; EP, educational program; HD, hemodialysis; PD, peritoneal dialysis; UPS, unplanned dialysis start.

Table 4 Dialysis modality costs according to preferred modality choice following UPS (n=177), actual modality received by these patients, and calculated costs derived for usual care modality distribution

Modality distribution	PD cost (€)	HD cost (€)	Total cost (€)
177 patients according to their preferred choice of modality	3,090,000	3,130,200	6,220,200
177 patients according to actual modality received	2,790,000	3,553,200	6,343,200
177 patients according to usual care^Citation11	540,000	6,725,700	7,265,700

Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; UPS, unplanned dialysis start.

RiouxJPCheemaHBargmanJMWatsonDChanCTEffect of an in-hospital chronic kidney disease education program among patients with unplanned urgent-start dialysisClin J Am Soc Nephrol20116479980421212422

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