ReviewJournal of general internal medicine2013
Dialysis in the frail elderly--a current ethical problem, an impending ethical crisis.
Review in Journal of general internal medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 35 citations in OpenAlex.
- Personalized Hemodialysis Approaches in Frail Older Individuals.Geriatrics (Basel, Switzerland) · 2026Review
- Comprehensive Conservative Management as Rescue Therapy After Haemodialysis Failure: Two Case Reports.Clinics and practice · 2026Article
- Dependency and frailty in the older haemodialysis patient.BMC geriatrics · 2024Observational
- Development and Acceptability of a Kidney Therapy Decision Aid for Patients Aged 75 Years and Older: A Design-Based Research Involving Patients, Caregivers, and a Multidisciplinary Team.Kidney medicine · 2023Article
- Changing landscape of dialysis withdrawal in patients with kidney failure: Implications for clinical practice.Nephrology (Carlton, Vic.) · 2022Review
- Older Patients with Advanced Chronic Kidney Disease and Their Perspectives on Prognostic Information: a Qualitative Study.Journal of general internal medicine · 2022Article
- Ethical challenges in nephrology: a call for action.Nature reviews. Nephrology · 2020Review
- Requests for futile treatments: what mechanisms play a role? Results of a qualitative study among Dutch physicians.BMJ open · 2020Article
- The strange case of Mr. H. Starting dialysis at 90 years of age: clinical choices impact on ethical decisions.BMC medical ethics · 2017Article
- The impact of frailty on outcomes in dialysis.Current opinion in nephrology and hypertension · 2017Review
- Palliative care for patients with end-stage renal disease: approach to treatment that aims to improve quality of life and relieve suffering for patients (and families) with chronic illnesses.Clinical kidney journal · 2017Article
- The Evolving Ethics of Dialysis in the United States: A Principlist Bioethics Approach.Clinical journal of the American Society of Nephrology : CJASN · 2016Article
- Article
- Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study.Clinical interventions in aging · 2016Article
- The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review.PloS one · 2016Article
- When is an invasive palliative intervention in an acute internal medical patient worth it? A structured palliative approach.Wiener medizinische Wochenschrift (1946) · 2015Article
- The Ethics of Chronic Dialysis for the Older Patient: Time to Reevaluate the Norms.Clinical journal of the American Society of Nephrology : CJASN · 2015Article
- Predictors of outpatient kidney function recovery among patients who initiate hemodialysis in the hospital.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2015Article
- Patient-centered care: an opportunity to accomplish the "Three Aims" of the National Quality Strategy in the Medicare ESRD program.Clinical journal of the American Society of Nephrology : CJASN · 2014Article
- High cost and low survival rate in high comorbidity incident elderly hemodialysis patients.PloS one · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
The current practice of hemodialysis for the frail elderly frequently ignores core bioethical principles. Lack of transparency and shared decision making coupled with financial incentives to treat have resulted in problems of overtreatment near the end of life. Imminent changes in reimbursement for hemodialysis will reverse the financial incentives to favor not treating high-risk patients. In this article, we describe what is empirically known about the approach to hemodialysis today, and how it violates four core ethical principles. We then discuss how the new financial system turns physician and organizational incentives upside down in ways that may exacerbate the ethical dilemmas, but in the opposite direction.
Indexed as
Identifiers
What OpenQuestion holds
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.