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Abstract Background and Aims Patients with chronic kidney disease (CKD) require shared decision-making (SDM) processes when choosing a dialysis method. Peritoneal dialysis (PD) guarantees patient autonomy; thus, SDM is even more important. Based on these findings, we aim to highlight the benefits of PD and increase the rate in which patients choose PD. In order to increase the rate of PD implementation, patients must actively participate in dialysis decisions, and SDM process is necessary between doctors and patients. So, we investigated the effect of SDM on the prognosis of patients with CKD. We focused on the effects of SDM on patient death, survival rates, hemodialysis conversion, emergency room visits, hospitalization days, and outpatient visits. The results of this study suggest that SDM has a positive impact on increasing the number of patients who choose PD and reduce unnecessary medical cost. Method Among patients with chronic kidney failure from eight hospitals in Korea who started dialysis, 256 who participated in a pilot project for home management of PD were included in the present study. A mixed-methods study was conducted using questionnaires and semi-structured interviews. Our study focused on the effects of SDM on patient death, survival rate, hemodialysis conversion, emergency room visits, hospitalization days, and outpatient visits. Results A significant difference was observed in the number of days of hospitalization per admission (p = 0.0044) between the SDM and non-SDM groups. However, no significant differences were observed in survival rate, rate of conversion to hemodialysis (HD), survival rate after conversion to HD, emergency room visit rate, number of hospitalizations per patient, outpatient visit rate, medical cost, hospitalization cost, outpatient cost, and phosphate-binding agent prescription rate. Conclusion The number of hospitalization days per admission decreased throughout the SDM process. Continued communication between patients and medical staff on how to manage PD in the long term after making the decision to undergo dialysis will be beneficial in promoting the home management of PD patients.
Shin et al. (Wed,) studied this question.