ReviewPediatric nephrology (Berlin, Germany)2015
Sustaining life or prolonging dying? Appropriate choice of conservative care for children in end-stage renal disease: an ethical framework.
Review in Pediatric nephrology (Berlin, Germany), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Management of congenital nephrotic syndrome: consensus recommendations of the ERKNet-ESPN Working Group.Nature reviews. Nephrology · 2021Guideline
- Prospective surveillance study of conservative kidney care in the UK and the Republic of Ireland: a British Paediatric Surveillance Unit study.Archives of disease in childhood · 2026Article
- Now what: navigating care of maternal/fetal dyads with bilateral renal agenesis after RAFT. A physician and parent point of view.Pediatric nephrology (Berlin, Germany) · 2025Article
- The spectrum of co-existing disease in children with established kidney failure using registry and linked electronic health record data.Pediatric nephrology (Berlin, Germany) · 2024Article
- Caregiver perspectives of dialysis initiation for children with kidney disease: a qualitative study.Pediatric nephrology (Berlin, Germany) · 2022Article
- Decision Making in the Context of Paediatric Solid Organ Transplantation Medicine.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- Palliative care for children and young people with stage 5 chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2022Article
- Addressing the Ethical Challenges of Providing Kidney Failure Care for Children: A Global Stance.Frontiers in pediatrics · 2022Review
- Health professionals' perception of appropriateness of care: a qualitative study in Italian pediatric hospices.Acta bio-medica : Atenei Parmensis · 2020Article
- Caregiver burden in pediatric dialysis.Pediatric nephrology (Berlin, Germany) · 2020Review
- Perceptions of patients with end-stage kidney disease (ESKD) and their informal caregivers on palliative care as a treatment option: a qualitative study.BMC palliative care · 2020Article
- Renal Replacement Therapy in children with severe developmental disability: guiding questions for decision-making.European journal of pediatrics · 2018Article
- Causes of renal oligohydramnios: impact on prenatal counseling and postnatal outcome.Pediatric nephrology (Berlin, Germany) · 2018Article
- Prenatal parental decision-making and postnatal outcome in renal oligohydramnios.Pediatric nephrology (Berlin, Germany) · 2018Article
- Management dilemmas in pediatric nephrology: time-limited trials of dialysis therapy.Pediatric nephrology (Berlin, Germany) · 2017Article
- Severe antenatally diagnosed renal disorders: background, prognosis and practical approach.Pediatric nephrology (Berlin, Germany) · 2016Review
- Conflict in a paediatric hospital: a prospective mixed-method study.Archives of disease in childhood · 2016Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Due to technological advances, an increasing number of infants and children are surviving with multi-organ system dysfunction, and some are reaching end-stage renal disease (ESRD). Many have quite limited life expectancies and may not be eligible for kidney transplantation but families request dialysis as alternative. In developed countries where resources are available there is often uncertainty by the medical team as to what should be done. After encountering several of these scenarios, we developed an ethical decision-making framework for the appropriate choice of conservative care or renal replacement therapy in infants and children with ESRD. The framework is a practical tool to help determine if the burdens of dialysis would outweigh the benefits for a particular patient and family. It is based on the four topics approach of medical considerations, quality-of-life determinants, patient and family preferences and contextual features tailored to pediatric ESRD. In this article we discuss the basis of the criteria, provide a practical framework to guide these difficult conversations, and illustrate use of the framework with a case example. While further research is needed, through this approach we hope to reduce the moral distress of care providers and staff as well as potential conflict with the family in these complex decision-making situations.
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.