[Guiding the patient with end-stage renal disease in the choice of replacement therapy: role of the predialysis outpatient department].

The predialysis outpatient department has three main objectives: ensuring patients' conscious and informed choice of dialysis treatment; clinical followup of patients with stage IV-V kidney disease; supporting patients and their families in their treatment choice. The aim of this work is to evaluate a) the effectiveness of the predialysis outpatient department in informing patients about the problems inherent in their disease; b) the differences in the choice of dialysis treatment between patients who benefited from the predialysis program and those who did not have that opportunity. Ninety-six patients were included in the study: 77 started renal replacement therapy after following a program at the predialysis outpatient department, while the remaining 19 patients started dialysis in an unplanned way. The patients monitored during predialysis were given a questionnaire to evaluate the usefulness of the followed program. The 77 patients who attended the predialysis outpatient department proved to be equally divided between hemodialysis and peritoneal dialysis: 43% vs 57%; the other 19 patients were directed mainly towards hemodialysis: 86% vs 14%, respectively. Analysis of the questionnaires showed that patients expressed a good degree of satisfaction. The results pointed to the usefulness of creating a predialysis outpatient department that should be able to a) optimize the predialytic treatments; b) plan the preparation of vascular or peritoneal access; c) guarantee patients a conscious choice of their replacement therapy.