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Kidney Disease Risk Survey

As a person living with kidney disease, we would like to understand what you think is most important to know about events that could happen in your lifetime, such as needing dialysis or a kidney transplant, or developing heart disease.

This survey asks 2 questions about times and events that could be important to you. There is no right or wrong answer. We only wish to understand your preferences.

This survey is anonymous. You will not be identified in any database or summary of results. This survey is also voluntary. You don’t have to complete it if you would rather not.

Thank you for your participation!

Question 1. It is important for me to know my personal risk of needing dialysis or a kidney transplant over the next… (check all that apply)

	Not at all Important	Somewhat Important	Important	Very Important	Extremely Important
1 year
3 years
5 years
10 years
15 years

I do not think of risk of needing dialysis or a kidney transplant like this
I do not want to know my exact risk of needing dialysis or a kidney transplant

Question 2. It is important for me to know my personal risk of developing heart disease over the next… (check all that apply)

	Not at all Important	Somewhat Important	Important	Very Important	Extremely Important
1 year
3 years
5 years
10 years
15 years

I do not think of risk of developing heart disease like this
I do not want to know my exact risk of developing heart disease