Knowledge, attitude, and practice of nephrologists on the decision for renal replacement therapy.

ABSTRACT

BACKGROUND: This study aimed to investigate the Knowledge, Attitude, and Practice (KAP) of nephrologists on the decision of renal replacement therapy (RRT), including peritoneal dialysis, hemodialysis, and kidney transplantation. METHODS: This multicenter cross-sectional study was conducted on qualified nephrologists who volunteered to participate between July and August 2022 by using a self-administered questionnaire. RESULTS: Among 327 nephrologists, the total knowledge, attitude, and practice scores were 12.03 ± 2.11/16, 58.39 ± 6.62/75, and 27.15 ± 2.74/30, respectively. Multivariate logistic regression analysis showed that the attitude score (peritoneal dialysis OR = 1.19, 95%CI 1.13-1.25, P < 0.001; hemodialysis OR = 1.14, 95%CI 1.09-1.19, P < 0.001; kidney transplantation OR = 1.12, 95%CI 1.07-1.16, P < 0.001), 41-50 years of age (peritoneal dialysis OR = 0.45, 95%CI 0.21-0,98, P = 0.045; hemodialysis OR = 0.27, 95%CI 0.12-0.60, P = 0.001; kidney transplantation OR = 0.45, 95%CI0.20-0.97, P = 0.042), and > 50 years of age (peritoneal dialysis OR = 0.27, 95%CI 0.08-0.84, P = 0.024; hemodialysis OR = 0.45, 95%CI 0.20-0.97, P = 0.042; kidney transplantation OR = 0.24, 95%CI 0.08-0.77, P = 0.016) were independently associated with the consideration score of peritoneal dialysis, hemodialysis, and kidney transplantation. CONCLUSION: Better attitudes may lead to more consideration by nephrologists when choosing between peritoneal dialysis, hemodialysis, and kidney transplantation and relatively less consideration by senior physicians when making decisions; in addition, having good knowledge and good attitudes may lead to better practice.