Trial reportNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2013
Patient perspectives on informed decision-making surrounding dialysis initiation.
Trial report in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06799936 (A Communication-Priming Intervention to Improve Shared Decision-Making Between Older Adults With Advanced Chronic Kidney Disease and Clinicians), which is not on this map. Cited by 88 papers, 5 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.
A Communication-Priming Intervention to Improve Shared Decision-Making Between Older Adults With Advanced Chronic Kidney Disease and Clinicians: A Cluster-Randomized Controlled Trial
Who cites it
88 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Effectiveness of patient decision aids in patients with advanced kidney disease: a meta-analysis based on randomized controlled trials.International urology and nephrology · 2024Pooled it
- Pooled it
- Socioeconomic status and mortality among dialysis patients: a systematic review and meta-analysis.International urology and nephrology · 2019Pooled it
- Advance care planning for haemodialysis patients.The Cochrane database of systematic reviews · 2016Pooled it
- 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
- Feasibility and Acceptability of a Palliative Care Intervention among Older Adults with Advanced CKD and Their Caregivers.Kidney360 · 2025Trial
- Effectiveness of an Advance Care Planning Intervention in Adults Receiving Dialysis and Their Families: A Cluster Randomized Clinical Trial.JAMA network open · 2024Trial
- The extent of informed decision-making about starting dialysis: does patients' age matter?Journal of nephrology · 2014Trial
- Navigating prognostic uncertainty with H.O.P.E.: Caring for elderly patients with chronic kidney disease.Patient education and counseling · 2026Article
- Nephrologist Affiliation With Dialysis Facilities and Patient Trajectories in End-Stage Kidney Disease.JAMA network open · 2026Article
- Decisional Conflict and Patient Experiences in Dialysis Treatment Decision-Making: A Mixed-Methods Study in a Portuguese Cohort.Healthcare (Basel, Switzerland) · 2026Article
- Hospice Referral Rate Disparities of American Indian/Alaska Native Kidney Transplant Recipients with End-Stage Kidney Disease: A Retrospective Cohort Analysis.The American journal of hospice & palliative care · 2026Article
- An Initiative to Improve Nephrology Clinician Confidence in Shared Decision Making.Kidney medicine · 2026Article
- An Integrated, Evidence-Guided Framework for Chronic Kidney Disease Self-Management: Behavioral Mechanisms, Implementation Strategies, and Real-World Application.Kidney & blood pressure research · 2026Review
- Decision support training for chronic kidney disease dyads: the ImPart Study protocol.Pilot and feasibility studies · 2025Article
- Supporting Shared Decision-Making in Life-Altering Kidney Therapy Decisions for Older Adults: A Review.JAMA internal medicine · 2025Review
- Shared decision-making for kidney replacement therapy: a comprehensive review and a proposed model.The Korean journal of internal medicine · 2025Review
- Quality Metrics in Dialysis: It Takes a Village.Advances in kidney disease and health · 2025Review
- Population Health Management for Improving Kidney Health Outcomes.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundCareful patient-clinician shared decision-making about dialysis initiation has been promoted, but few studies have addressed patient perspectives on the extent of information provided and how decisions to start dialysis are made.
methodsNinety-nine maintenance dialysis patients recruited from 15 outpatient dialysis centers in North Carolina completed semistructured interviews on information provision and communication about the initiation of dialysis. These data were examined with content analysis. In addition, informed decision-making (IDM) scores were created by summing patient responses (yes/no) to 10 questions about the decision-making.
resultsThe mean IDM score was 4.4 (of 10; SD = 2.0); 67% scored 5 or lower. Age at the time of decision-making (r = -0.27, P = 0.006), years of education (r = 0.24, P = 0.02) and presence of a warning about progressing to end-stage kidney disease (t = 2.9, P = 0.005) were significantly associated with IDM scores. Nearly 70% said that the risks and burdens of dialysis were not mentioned at all, and only one patient recalled that the doctor offered the option of not starting dialysis. While a majority (67%) said that they felt they had no choice about starting dialysis (because the alternative would be death) or about dialysis modality, only 21.2% said that they had felt rushed to make a decision. About one-third of the patients perceived that the decision to start dialysis and modality was already made by the doctor.
conclusionsA majority of patients felt unprepared and ill-informed about the initiation of dialysis. Improving the extent of IDM about dialysis may optimize patient preparation prior to starting treatment and their perceptions about the decision-making process.
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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.