ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2012
Discussions of the kidney disease trajectory by elderly patients and nephrologists: a qualitative study.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04466865 (Best Case/Worst Case), which is not on this map. Cited by 113 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Best Case/Worst Case: A Multisite Randomized Clinical Trial of Scenario Planning for Patients With End-Stage Kidney Disease
Who cites it
113 citing papers in PubMed, 8 syntheses or guidelines pooled it, 249 citations in OpenAlex.
- Mortality Risk Prediction Models for People With Kidney Failure: A Systematic Review.JAMA network open · 2025Pooled it
- Non-medical barriers reported by nephrologists when providing renal replacement therapy or comprehensive conservative management to end-stage kidney disease patients: a systematic review.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Pooled it
- Impact of hearing loss on clinical interactions between older adults and health professionals: a systematic review.European geriatric medicine · 2020Pooled it
- Towards the best kidney failure prediction tool: a systematic review and selection aid.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020Pooled it
- Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies.BMJ open · 2018Pooled it
- How long do patients with chronic disease expect to live? A systematic review of the literature.BMJ open · 2016Pooled it
- Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care.Kidney international · 2015Guideline
- Patient and health care professional decision-making to commence and withdraw from renal dialysis: a systematic review of qualitative research.Clinical journal of the American Society of Nephrology : CJASN · 2015Pooled it
- Trial
- Prediction of the Mortality Risk in Peritoneal Dialysis Patients using Machine Learning Models: A Nation-wide Prospective Cohort in Korea.Scientific reports · 2020Trial
- The extent of informed decision-making about starting dialysis: does patients' age matter?Journal of nephrology · 2014Trial
- Patient perspectives on informed decision-making surrounding dialysis initiation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2013Trial
- Navigating prognostic uncertainty with H.O.P.E.: Caring for elderly patients with chronic kidney disease.Patient education and counseling · 2026Article
- Long-term frailty progression and mortality in hemodialysis: Impact of dialysis duration and baseline frailty in a nationwide Japanese cohort.Clinical and experimental nephrology · 2026Article
- Engaging Dialysis Teams in Shared Decision-Making Conversations With Patients to Improve Rates of Kidney Transplantation.Kidney medicine · 2026Article
- Decisional Conflict and Patient Experiences in Dialysis Treatment Decision-Making: A Mixed-Methods Study in a Portuguese Cohort.Healthcare (Basel, Switzerland) · 2026Article
- External validation of a prognostic model in routine practice for short- and long-term survival in peritoneal dialysis.Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis · 2026Article
- Response to the Letter to the Editor Entitled: Conservative Kidney Management as an Integral Part of Shared Decision-Making in Advanced CKD.Kidney international reports · 2026Article
- Charlson comorbidity index and palliative performance scale predict prognosis in dialysis patients: a retrospective cohort study.BMC palliative care · 2026Article
- Living with haemodialysis in Sri Lanka: a qualitative study on patient adaptation and care perceptions.BMC nephrology · 2026Article
53 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundElderly patients with advanced kidney disease experience considerable disability, morbidity, and mortality. Little is known about the impact of physician-patient interactions on patient preparation for the illness trajectory. We sought to describe how nephrologists and older patients discuss and understand the prognosis and course of kidney disease leading to renal replacement therapy.
methodsWe conducted focus groups and interviews with 11 nephrologists and 29 patients older than 65 years with advanced chronic kidney disease or receiving hemodialysis. Interviews were audiorecorded and transcribed. We used qualitative analytic methods to identify common and recurrent themes related to the primary research question.
resultsWe identified 6 themes that describe how the kidney disease trajectory is discussed and understood: (1) patients are shocked by their diagnosis, (2) patients are uncertain how their disease will progress, (3) patients lack preparation for living with dialysis, (4) nephrologists struggle to explain illness complexity, (5) nephrologists manage a disease over which they have little control, and (6) nephrologists tend to avoid discussions of the future. Patients and nephrologists acknowledged that prognosis discussions are rare. Patients tended to cope with thoughts of the future through avoidance by focusing on their present clinical status. Nephrologists reported uncertainty and concern for evoking negative reactions as barriers to these conversations.
conclusionsPatients and nephrologists face challenges in understanding and preparing for the kidney disease trajectory. Communication interventions that acknowledge the role of patient emotion and address uncertainty may improve how nephrologists discuss disease trajectory with patients and thereby enhance their understanding and preparation for the future.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.