Results Summary

What was the research about?

Chronic kidney disease (CKD) is a health problem in which the kidneys do not work well to remove waste from the blood. Some people with CKD have kidney failure, which means that they lose most of their kidney function. As kidneys fail, most people will need to choose between two common treatments

  • Hemodialysis, which is treatment with a machine that cleans the blood. Patients receive this procedure at a treatment center.
  • Peritoneal dialysis, which is pumping a cleansing fluid into the belly through a tube and then letting it drain out again, taking wastes away with the fluid. Patients can do this treatment at home or work.

For this study, the research team created and tested an online decision aid. Decision aids help people choose between two or more treatments based on what is most important to them. The decision aid in this study gave patients information on CKD and compared the two treatment options. The research team wanted to learn if the decision aid increased patients’ knowledge about CKD and helped them with their decision. 

What were the results?

The decision aid increased

  • What patients knew about CKD and treatment options
  • How sure patients were about what was most important to them in choosing between treatments
  • How sure patients felt about which treatment they would choose

The decision aid didn’t change patients’ self-confidence in their ability to decide which treatment would be best for them.

Who was in the study?

The study included 140 patients with advanced CKD who had not started dialysis. The average patient age was 59. About 77 percent of patients in the study were white, and 16 percent were African American. Almost all patients had at least a high school degree, and 94 percent spoke English as their native language.

What did the research team do?

The research team assigned patients to one of two groups by chance. One group used the decision aid, and the other group didn’t. Patients in the first group took a survey before and after using the decision aid. The survey asked patients what they knew about CKD and asked them about how they make decisions about treatment. Patients in the second group took the survey only once. A panel of patients, caregivers, social workers, and doctors provided input on the study.

What were the limits of the study?

Patients who took part in the study were younger and healthier, and they had more education, than the average person with advanced CKD in the United States. The effect of the decision aid may not be the same for other groups of people.

Future research could test the decision aid in more CKD treatment centers with more patients. Future studies could also compare this new decision aid to existing ways of helping patients decide between dialysis treatment options.

How can people use the results?

Patients with advanced CKD may consider using decision aids such as the one in this study to learn more about dialysis options and help decide which treatment best matches their needs and preferences.

Final Research Report

View this project's final research report.

More to Explore...


Francesca Tentori, MD, MS; Arbor Research Collaborative for Health
Dr. Tentori discusses her project to develop a decision-aid tool for patients with kidney disease deciding which treatment type to choose.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also confirms that the research has followed PCORI’s Methodology Standards. During peer review, experts who were not members of the research team read a draft report of the research. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. Reviewers do not have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve how the research team analyzed its results or reported its conclusions. Learn more about PCORI’s peer-review process here.

In response to peer review, the PI made changes including

  • Revising the methods sections for Aims 2 and 3 to better address the PCORI Methodology Standards
  • Revising the discussion of Aim 3 results to better illustrate how the decision aid created in the study might be different from other decision aids in helping dialysis patients make treatment choices
  • Removing redundant information in the background section of the report
  • Adding suggested tables and figures to improve the readability of the report

Conflict of Interest Disclosures

Project Information

Lalita Subramanian, PhD, MPH^
Arbor Research Collaborative for Health
Selection of Peritoneal Dialysis or Hemodialysis for Kidney Failure: Gaining Meaningful Information for Patients and Caregivers

Key Dates

December 2012
January 2018

Study Registration Information

^Francesca Tentori, MD, MS, was the original PI on this project.


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Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
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Last updated: November 30, 2022