Evidence map›Paper›PMID 29331475›Full record

ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2018

End-of-Life Care for Patients With Advanced Kidney Disease in the US Veterans Affairs Health Care System, 2000-2011.

Susan P Y Wong, Margaret K Yu, Pamela K Green, Chuan-Fen Liu, Paul L Hebert, Ann M O'Hare

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.

  1. Survival of patients who opt for dialysis versus conservative care: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Review
  9. Review
  10. Establishing Research Priorities in Geriatric Nephrology: A Delphi Study of Clinicians and Researchers.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025
    Article
  11. Article
  12. Dialysis in the Elderly: A Practical Guide for the Clinician.International journal of nephrology · 2025
    Review
  13. Article
  14. Article
  15. Article
  16. Description and Outcomes of an Innovative Concurrent Hospice-Dialysis Program.Journal of the American Society of Nephrology : JASN · 2022
    Article
  17. Palliative Care in the Advancing American Kidney Health Initiative: A Call for Inclusion in Kidney Care Delivery Models.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2020
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Susan P Y WongHealth Service Research and Development Center of Innovation, VA Puget Sound Health Care System, Seattle, WA; Department of Medicine, University of Washington, Seattle, WA. Electronic address: spywong@uw.edu.
Margaret K YuDepartment of Medicine, Stanford University, Palo Alto, CA.
Pamela K GreenHealth Service Research and Development Center of Innovation, VA Puget Sound Health Care System, Seattle, WA.
Chuan-Fen LiuHealth Service Research and Development Center of Innovation, VA Puget Sound Health Care System, Seattle, WA; Department of Health Services, University of Washington, Seattle, WA.
Paul L HebertHealth Service Research and Development Center of Innovation, VA Puget Sound Health Care System, Seattle, WA; Department of Health Services, University of Washington, Seattle, WA.
Ann M O'HareHealth Service Research and Development Center of Innovation, VA Puget Sound Health Care System, Seattle, WA; Department of Medicine, University of Washington, Seattle, WA.
VA Puget Sound Health Care System · USUniversity of Washington · USStanford University · US

Funding

Dialysis decision-making among adults with advanced kidney diseaseK23DK107799 · NIDDK · UNIVERSITY OF WASHINGTON · PI WONG, SUSAN PAMELA · 2016 to 2019
$657k
NIDDK NIH HHS K23 DK107799
6 · The paper itself

Abstract

backgroundLittle is known about patterns of end-of-life care for patients with advanced kidney disease not treated with maintenance dialysis. STUDY

designCase series. SETTING &

participantsA sample of 14,071 patients with sustained estimated glomerular filtration rates < 15mL/min/1.73m OUTCOMES: Hospitalization and receipt of an intensive procedure during the final month of life, in-hospital death, and palliative care consultation and hospice enrollment before death.

resultsCompared with decedents treated with dialysis, those for whom a decision not to pursue dialysis therapy had been made were less often hospitalized (57.3% vs 76.8%; OR, 0.40 [95% CI, 0.34-0.46]), less often the recipient of an intensive procedure (3.5% vs 24.6%; OR, 0.15 [95% CI, 0.10-0.22]), more often the recipient of a palliative care consultation (52.6% vs 21.6%; OR, 4.19 [95% CI, 3.58-4.90]), more often used hospice services (38.7% vs 18.2%; OR, 3.32 [95% CI, 2.83-3.89]), and died less frequently in a hospital (41.4% vs 57.3%; OR, 0.78 [95% CI, 0.74-0.82]). Hospitalization (55.5%; OR, 0.39 [95% CI, 0.32-0.46]), receipt of an intensive procedure (13.7%; OR, 0.60 [95% CI, 0.46-0.77]), and in-hospital death (39.0%; OR, 0.47 [95% CI, 0.39-0.56]) were also less common among decedents who had been discussing and/or preparing for dialysis therapy, but their use of palliative care and hospice services was similar. LIMITATIONS: Findings may not be generalizable to groups not well represented in the Veterans Affairs health care system.

conclusionsAmong decedents, patients not treated with dialysis before death received less intensive patterns of end-of-life care than those treated with dialysis. Decedents for whom there had been a decision not to pursue dialysis therapy before death were more likely to receive palliative care and hospice.

Indexed as

VeteransAgedAged, 80 and overFemaleHospice CareHumansKidney Failure, ChronicMaleMiddle AgedPalliative CareRetrospective StudiesTerminal CareUnited StatesUnited States Department of Veterans AffairsChronic kidney disease (CKD)conservative caredialysisend-of-life carehealth care intensityhospiceintensive treatmentkidney failurepalliative care

Identifiers

PMID29331475
PMCPMC6019112
OpenAlexW2783983971

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.