Patient information about options for treatment: Methods of a national audit of information provision in chronic kidney disease

Abstract

The new CARI guidelines for 'Acceptance onto dialysis' suggest patients with chronic kidney disease are referred to a nephrologist at an estimated glomerular filtration rate of <30 ml/min per 1.73 m², to allow 3-6 months for pre-dialysis education, creation of dialysis access, and planned initiation of renal replacement therapy or conservative management. Similarly, international guidelines recommend education for patients and their families occurs 6 to 12 months prior to the predicted onset of end stage kidney disease or during Stage 4 or Stage 5 chronic kidney disease. However, some patients commencing treatment may not receive information about their options at a time that facilitates effective and informed decision making or that enables consideration of treatment other than centre-based haemodialysis. Implementation of chronic kidney disease education guidelines has not been widely reported and there are few published studies that assess the provision and delivery of information about all treatment options. Patient INformation about Options for Treatment (PINOT) is a prospective national audit of the type and timing of information provided by renal units to incident pre-emptive transplant, dialysis and conservatively managed patients over a 3-month period. PINOT will assess the patient and unit characteristics associated with timely information provision and highlight any regional variation in treatments offered.