SynthesisClinical journal of the American Society of Nephrology : CJASN2015
Patient and health care professional decision-making to commence and withdraw from renal dialysis: a systematic review of qualitative research.
Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2015. 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 55 papers, 5 of them syntheses 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.
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
55 citing papers in PubMed, 5 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Decisional Conflicts in Kidney Replacement Therapy for Patients With Grade 5 Chronic Kidney Disease: A Qualitative Meta-Synthesis.Journal of renal care · 2025Pooled it
- The experience of nurses when providing care across acts that may be perceived as death hastening: A qualitative evidence synthesis.Palliative medicine · 2025Pooled it
- Patient engagement during the transition from nondialysis-dependent chronic kidney disease to dialysis: A meta-ethnography.Health expectations : an international journal of public participation in health care and health policy · 2023Pooled it
- Long-term Outcomes Among Patients With Advanced Kidney Disease Who Forgo Maintenance Dialysis: A Systematic Review.JAMA network open · 2022Pooled it
- Factors promoting shared decision-making in renal replacement therapy for patients with end-stage kidney disease: systematic review and qualitative meta-synthesis.International urology and nephrology · 2022Pooled it
- Navigating prognostic uncertainty with H.O.P.E.: Caring for elderly patients with chronic kidney disease.Patient education and counseling · 2026Article
- Decisional Conflict and Patient Experiences in Dialysis Treatment Decision-Making: A Mixed-Methods Study in a Portuguese Cohort.Healthcare (Basel, Switzerland) · 2026Article
- Decision support training for chronic kidney disease dyads: the ImPart Study protocol.Pilot and feasibility studies · 2025Article
- Shared decision-making for kidney replacement therapy: a comprehensive review and a proposed model.The Korean journal of internal medicine · 2025Review
- How do patient information documents present dialysis and conservative kidney management? A document analysis.Clinical kidney journal · 2025Article
- Profiling mortality patterns and place of death in patients on maintenance hemodialysis: a retrospective study in a tertiary care academic hospital in India.BMC palliative care · 2025Article
- Article
- Communicating treatment options to older patients with advanced kidney disease: a conversation analysis study.BMC nephrology · 2024Observational
- Providers' Experiences Discussing Care for Patients with Kidney Failure Who Forgo KRT: A National Qualitative Study.Clinical journal of the American Society of Nephrology : CJASN · 2024Article
- Concurrent Hospice and Dialysis Care: Considerations for Implementation.Journal of general internal medicine · 2024Article
- Choosing conservative care in advanced chronic kidney disease: a scoping review of patients' perspectives.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Unravelling complex choices: multi-stakeholder perceptions on dialysis withdrawal and end-of-life care in kidney disease.BMC nephrology · 2024Article
- Effect of ethnicity and socioeconomic deprivation on uptake of renal supportive care and dialysis decision-making in older adults.Clinical kidney journal · 2023Article
- Current trends in hospice care usage for dialysis patients in the USA.Journal of nephrology · 2023Article
- Decision aids to assist patients and professionals in choosing the right treatment for kidney failure.Clinical kidney journal · 2023Review
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 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveTo ensure that decisions to start and stop dialysis in ESRD are shared, the factors that affect patients and health care professionals in making such decisions must be understood. This systematic review sought to explore how and why different factors mediate the choices about dialysis treatment. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: MEDLINE, Embase, CINAHL, and PsychINFO were searched for qualitative studies of factors that affect patients' or health care professionals' decisions to commence or withdraw from dialysis. A thematic synthesis was conducted.
resultsOf 494 articles screened, 12 studies (conducted from 1985 to 2014) were included. These involved 206 patients (most receiving hemodialysis) and 64 health care professionals (age ranges: patients, 26-93 years; professionals, 26-61 years). For commencing dialysis, patients based their choice on "gut instinct," as well as deliberating over the effect of treatment on quality of life and survival. How individuals coped with decision-making was influential: Some tried to take control of the problem of progressive renal failure, whereas others focused on controlling their emotions. Health care professionals weighed biomedical factors and were led by an instinct to prolong life. Both patients and health care professionals described feeling powerless. With regard to dialysis withdrawal, only after prolonged periods on dialysis were the realities of life on dialysis fully appreciated and past choices questioned. By this stage, however, patients were physically dependent on treatment. As was seen with commencing dialysis, individuals coped with treatment withdrawal in a problem- or emotion-controlling way. Families struggled to differentiate between choosing versus allowing death. Health care teams avoided and queried discussions regarding dialysis withdrawal. Patients, however, missed the dialogue they experienced during predialysis education.
conclusionsDecision-making in ESRD is complex and dynamic and evolves over time and toward death. The factors at work are multifaceted and operate differently for patients and health professionals. More training and research on open communication and shared decision-making are needed.
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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.