What is the role of nephrologists and nurses of the dialysis department in providing fertility care to CKD patients?: A questionnaire study among care providers.mong Dutch neurologists

Purpose This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrolo- gists and nurses in the dialysis department. Methods Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N=312) and dialysis nurses (N=1211).   Results Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9.0% of the nephrologists and 15.6% of the nurses. 61.7% of the nephrologists and 23.6% of the nurses informed ≥50% of their patients on potential changes in fertility due to a decline in renal function. Fertility subjects discussed by nephrologists included “wish to have children” (91.2%), “risk of pregnancy for patients’ health” (85.8%), and “inheritance of the disease” (81.4%). Barriers withholding nurses from discussing FD were based on “the age of the patient” (62.6%), “insufficient training” (55.2%), and “language and ethnicity” (51.6%). 29.2% of the nurses felt competent in discussing fertility, 8.3% had sufficient knowledge about fertility, and 75.7% needed to expand their knowledge. More knowledge and competence were associated with providing fertility health care (p< 0.01).   Conclusions In most nephrology departments, the guide- lines to appoint which care provider should provide fertil- ity care to CKD patients are absent. Fertility counseling is routinely provided by most nephrologists, nurses often skip this part of care mainly due to insufficiencies in self- imposed competence and knowledge and barriers based on cultural diversity. The outcomes identified a need for fer- tility guidelines in the nephrology department and training and education for nurses on providing fertility care.   CC BY 4.0 https://creativecommons.org/licenses/by/4.0