Renal replacement therapy choices for pre-dialysis renal patients

Br J Nurs. 2005 Jun 23-Jul 13;14(12):659-64. doi: 10.12968/bjon.2005.14.12.18287.


With the numbers of patients developing end-stage renal failure predicted to increase over the coming years, more patients than ever will be expected to choose their future form of renal replacement treatment. This study explored the decision-making processes of pre-dialysis patients to elucidate how these choices were made. Nine pre-dialysis patients were interviewed, transcripts of which were analysed using interpretative phenomenological analysis. Four main themes relating to the decision-making process emerged: maintaining one's integrity, forced adaptation, utilizing information, and support and experiencing illness. While making a decision was an individualized process, contextualized within participants' illness experiences, these core themes emerged for the whole group, irrespective of the chosen treatment modality. For renal services, there is a need to tailor information provided to pre-dialysis patients and to become cognizant of the contexts in which they live and operate.

MeSH terms

  • Adult
  • Aged
  • Clinical Nursing Research
  • Decision Making
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Nurse-Patient Relations
  • Patient Education as Topic / methods
  • Patient Participation / methods*
  • Patient Participation / psychology*
  • Peer Group
  • Personal Autonomy
  • Qualitative Research
  • Renal Replacement Therapy / methods
  • Renal Replacement Therapy / nursing*
  • Renal Replacement Therapy / psychology*
  • Social Support