ArticleBMC nephrology2019
Older patients' experiences with a shared decision-making process on choosing dialysis or conservative care for advanced chronic kidney disease: a survey study.
Article in BMC nephrology, 2019. 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 23 papers, 2 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
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- ASN Kidney Health Guidance on Conservative Management in People with Kidney Failure.Journal of the American Society of Nephrology : JASN · 2026Guideline
- 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 · 2022Pooled it
- Survival of Older Adults Choosing Dialysis or Conservative Kidney Management, Stratified by Suitability for Dialysis.Kidney medicine · 2026Article
- Deciding between conservative kidney management and dialysis in older people with kidney failure: a narrative review.Clinical kidney journal · 2026Review
- Evaluation of a Decision Aid in Kidney Care Counseling for Older Adults.Kidney international reports · 2026Article
- Decisional Conflict and Patient Experiences in Dialysis Treatment Decision-Making: A Mixed-Methods Study in a Portuguese Cohort.Healthcare (Basel, Switzerland) · 2026Article
- Questions older people and caregivers ask about kidney therapies: A computer-assisted analysis.Patient education and counseling · 2025Article
- Shared Decision-Making in Choosing Dialysis Modalities for Patients With Chronic Kidney Disease: An Evolutionary Concept Analysis.Nursing & health sciences · 2025Review
- The trajectory of functional status of patients with kidney failure choosing conservative kidney management.International urology and nephrology · 2025Article
- 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
- 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
- Factors that influence the selection of conservative management for end-stage renal disease - a systematic review.Clinical kidney journal · 2024Article
- Shared decision making in chronic kidney disease: a qualitative study of the impact of communication practices on treatment decisions for older patients.BMC nephrology · 2023Article
- Kidney Clinicians' Perceptions of Challenges and Aspirations to Improve End-Of-Life Care Provision.Kidney international reports · 2023Article
- Patients' and healthcare professionals' perceived facilitators and barriers for shared decision-making for frail and elderly patients in perioperative care: a scoping review.BMC health services research · 2023Article
- Disparities in dialysis modality decision-making using a social-ecological lens: a qualitative approach.BMC nephrology · 2022Article
- Asking the right questions: towards a person-centered conception of shared decision-making regarding treatment of advanced chronic kidney disease in older patients.BMC medical ethics · 2022Article
- Patient Decision Aid Development for Older Adults With End-Stage Kidney Disease in Singapore.Kidney international reports · 2021Article
- Changing the choice from dialysis to conservative care or vice versa in older patients with advanced chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Article
- Information about different treatment options and shared decision making in dialysis care - a retrospective survey among hemodialysis patients.BMC health services research · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany older patients approaching end-stage kidney disease have to decide whether to go for dialysis or non-dialytic conservative care (CC). Shared decision-making is recommended to align the treatment plan with the patient's preferences and values. Little is known about older patients' experiences with shared decision-making on dialysis or CC.
methodsWe performed a survey study, in collaboration with the Dutch Kidney Patients Association, in 99 patients aged ≥70 years who had chosen dialysis (n = 75) or CC (n = 24) after a shared decision-making process involving an experienced multidisciplinary team.
resultsPatients stated to be overall satisfied with the shared decision-making process (% with score 6-10 on 11-point Likert scale, dialysis versus CC: 93% vs. 91%, P = 0.06), and treatment decision (87% vs. 91%, P = 0.03). However, patients also reported negative experiences, especially those who had chosen dialysis. Such negative experiences were related to the timing, informing, and level of decision-making being shared. More patients who selected dialysis indicated to have felt forced to make a decision, mostly due to the circumstances, such as their deteriorating health or kidney function, or by their nephrologist (31% vs. 5%, P = 0.01). Also, patients who selected dialysis mentioned a perceived lack of choice as most common reason for choosing dialysis, and 55% considered their own opinion as most important rather than their nephrologists' or relatives' opinion compared to 90% of the patients who had chosen CC (P = 0.02). A subset of patients who had chosen dialysis still doubted their treatment decision compared to no patient who had chosen CC (17% vs. 0%, P = 0.03).
conclusionsOlder patients reported contrasting experiences with shared decision-making on dialysis or CC. Despite high overall satisfaction, the underlying negative experiences illustrate important but modifiable barriers to an optimal shared decision-making process.
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Registered trials
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