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Nephrol Dial Transplant (1999) 14: 2616-2620
© 1999 European Renal Association-European Dialysis and Transplant Association

Dialysis and Transplantation News

Opinions regarding outcome differences in European and US haemodialysis patients

Claudio Ronco1 and Daniele Marcelli2

1 Department of Nephrology, St Bortolo Hospital, Vicenza, and 2 Lombardy Dialysis and Transplant Registry, Milan, Italy

Correspondence and offprint requests to: Dr Claudio Ronco, Department of Nephrology, St Bortolo Hospital, Viale Rodolfi, 36100 Vicenza, Italy.

Abstract

Study goal and design. The aim of this evaluation was to understand why outcomes seem to be different in different parts of the world. In an attempt to look at this question from a point of view other than that necessarily adopted by epidemiological studies, we decided to explore the personal opinion of a selected group of American (US) and European (EU) experts by means of a simple questionnaire. A 13-item questionnaire was sent to 14 internationally recognized opinion leaders in the field of haemodialysis: all seven Europeans and five of the seven Americans responded. The answers to each question were stratified in order to highlight the key differences between the experts in the different continents.

Results. Ten of the 12 respondents (six EU and four US) said that dialysis outcomes are better in Europe; nine (six EU and three US) confirmed their opinion after taking patient characteristics into account. When asked to suggest reasons for this difference, the highest score was given to the quality of procedures and medical training with no differences between EU and US physicians. This was followed by three other factors that received the same overall score (financial issues, doctor bedside time and quality of pre-dialysis care), but it is interesting to note that the Europeans attributed considerably greater importance to bedside time than their US counterparts.

Conclusion. It seems that the reported difference in dialysis outcomes between Europe and the US is a widely accepted fact. Although directed towards few respondents, our questionnaire does suggest some differences in the approach towards dialysis and end-stage renal disease patients.


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