LIVE AND LEARN - PATIENT EDUCATION DELAYS THE NEED TO INITIATE RENAL REPLACEMENT THERAPY IN END-STAGE RENAL-DISEASE

During a longitudinal study of the quality of life of end-stage renal disease, 204 patients with deteriorating renal function were identifie d before dialysis or transplantation was required to preserve their li ves. These patients were randomly assigned to either an enhanced or a standard education condition. The enhanced education condition consist ed of a specially prepared slide-lecture show concerning kidney diseas es and their treatment that was delivered by a trained research assist ant. The standard education condition consisted of whatever educationa l procedures were routinely available at the participating hospital. A ll but six patients have now started treatment by maintenance dialysis . Individuals in the enhanced education condition survived an average of 4.6 months longer than did those in the standard education group wi thout requiring the initiation of renal replacement therapy. This effe ct could not be attributed to physical differences between the groups, to cohort effects, to delays in contacting the patients, or to when o r where they were identified. Possible mechanisms for this effect are discussed.