ReviewClinical interventions in aging2013
Ageism vs. the technical imperative, applying the GRADE framework to the evidence on hemodialysis in very elderly patients.
Review in Clinical interventions in aging, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 41 citations in OpenAlex.
- Prediction of the Mortality Risk in Peritoneal Dialysis Patients using Machine Learning Models: A Nation-wide Prospective Cohort in Korea.Scientific reports · 2020Trial
- Using machine learning algorithms to predict MACE in peritoneal dialysis patients.Scientific reports · 2026Article
- Dependency and frailty in the older haemodialysis patient.BMC geriatrics · 2024Observational
- A prospective, observational study of frailty, quality of life and dialysis in older people with advanced chronic kidney disease.BMC geriatrics · 2023Observational
- Older Patients with Advanced Chronic Kidney Disease and Their Perspectives on Prognostic Information: a Qualitative Study.Journal of general internal medicine · 2022Article
- Developing a Tool for Evaluating Ageism in Nursing Care of Older People in Kashan/Iran.Journal of cross-cultural gerontology · 2019Article
- The Ethics of Chronic Dialysis for the Older Patient: Time to Reevaluate the Norms.Clinical journal of the American Society of Nephrology : CJASN · 2015Article
- Understanding by older patients of dialysis and conservative management for chronic kidney failure.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2015Article
- Palliative and end-of-life care issues in chronic kidney disease.Current opinion in supportive and palliative care · 2015Review
- 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
- Chronic kidney disease and the aging population.Journal of cross-cultural gerontology · 2014Article
- Chronic kidney disease and the aging population.Indian journal of nephrology · 2014Article
- Chronic kidney disease and the aging population.Journal of nephrology · 2014Review
- Chronic kidney disease and the aging population.International journal of organ transplantation medicine · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeTreatment intensity for elderly patients with end-stage renal disease has escalated beyond population growth. Ageism seems to have given way to a powerful imperative to treat patients irrespective of age, prognosis, or functional status. Hemodialysis (HD) is a prime example of this trend. Recent articles have questioned this practice. This paper aims to identify existing pre-synthesized evidence on HD in the very elderly and frame it from the perspective of a clinician who needs to involve their patient in a treatment decision. PATIENTS AND
methodsA comprehensive search of several databases from January 2002 to August 2012 was conducted for systematic reviews of clinical and economic outcomes of HD in the elderly. We also contacted experts to identify additional references. We applied the rigorous framework of decisional factors of the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) to evaluate the quality of evidence and strength of recommendations.
resultsWe found nine eligible systematic reviews. The quality of the evidence to support the current recommendation of HD initiation for most very elderly patients is very low. There is significant uncertainty in the balance of benefits and risks, patient preference, and whether default HD in this patient population is a wise use of resources.
conclusionFollowing the GRADE framework, recommendation for HD in this population would be weak. This means it should not be considered standard of care and should only be started based on the well-informed patient's values and preferences. More studies are needed to delineate the true treatment effect and to guide future practice and policy.
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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.