ArticleBMJ open2018
Decision-making for people with dementia and advanced kidney disease: a secondary qualitative analysis of interviews from the Conservative Kidney Management Assessment of Practice Patterns Study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Kidney supportive care in advanced chronic kidney disease: a qualitative meta-synthesis of healthcare professionals perspectives and attitudes.BMC nephrology · 2025Pooled it
- Nurse Practitioners' Experiences Navigating Treatment Decision-Making Affecting Older People with Neurocognitive Disorders and Cancer.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres · 2026Article
- Ten-Year Trend in the Potentially Inappropriate Prescribing of Renally-Dependent Medicines in Australian General Practice Patients with Dementia.Journal of clinical medicine · 2025Article
- Navigating healthcare decision-making for children requiring life-sustaining medical treatment in Ireland: exploring clinician perspectives through the lens of the Irish legal system.BMC medical ethics · 2025Article
- "You can't put your luck on people": a qualitative study of family views on the best interests decision-making process concerning adult kidney care in England.BMC nephrology · 2025Article
- Comprehensive Geriatric Assessment (CGA) and Optimisation Services in Older Kidney Patients: Results from the First UK-Wide Transplant Centre and Renal Unit Survey Study.Journal of clinical medicine · 2025Article
- Article
- Factors that influence the selection of conservative management for end-stage renal disease - a systematic review.Clinical kidney journal · 2024Article
- Smoothing transition to dialysis to improve early outcomes after dialysis initiation among old and frail adults-a narrative review.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022Review
- Dialysis decisions concerning cognitively impaired adults: a scoping literature review.BMC medical ethics · 2021Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo explore dialysis decision-making for adults who lack capacity due to cognitive impairment, a common and under-recognised condition in those with advanced chronic kidney disease (CKD).
designSecondary analysis of qualitative data collected during the Conservative Kidney Management Assessment of Practice Patterns Study programme of research was performed. Sixty semistructured interviews were conducted with multiprofessional team members from UK renal centres. Staff were asked about local facilities, the value of conservative kidney management (CKM), when and with whom CKM was discussed and how CKM could be improved. Thematic analysis was employed to identify, characterise and report on themes that emerged from the data, focused on the specific issues experienced by people with dementia.
settingA purposive sample of nine UK renal centres differing in the scale of their CKM programmes.
participantsClinical directors of renal centres identified staff involved in CKM. Staff were asked to participate if they had experience of low clearance clinics or of caring for patients with advanced CKD (estimated glomerular filtration rate <20mL/min/1.73
resultsTwo overarching themes were identified: factors taken into consideration during decision-making, and the process of decision-making itself. Comorbidity, social support, quality of life and the feasibility of dialysis were reported as factors pertinent to clinicians' decisions regarding suitability. The majority of renal centres practised multidisciplinary 'best interests' decision-making for those without capacity. Attitudes to advance care planning were divided.
conclusionsIn view of the prevalence of cognitive impairment among those with advanced CKD, we suggest consideration of routine assessment of cognition and capacity. In the UK, dialysis is initiated and continued for individuals with dementia and services should be adapted to meet the needs of this population.
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