ArticleBMC nephrology2020
Caring for older patients with advanced chronic kidney disease and considering their needs: a qualitative study.
Article in BMC nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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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.
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Who cites it
13 citing papers in PubMed.
- A Pilot Randomized Controlled Trial of Integrated Palliative Care and Nephrology Care.Kidney360 · 2022Trial
- Decision support training for chronic kidney disease dyads: the ImPart Study protocol.Pilot and feasibility studies · 2025Article
- How do older patients with advanced kidney disease, and their family members, understand kidney function and failure? A qualitative study.BMC nephrology · 2025Article
- How do patient information documents present dialysis and conservative kidney management? A document analysis.Clinical kidney journal · 2025Article
- 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
- Exploring Patient Needs and Preferences in CKD Education: A Cross-Sectional Survey Study.Kidney360 · 2024Article
- "Systems seem to get in the way": a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease.BMC nephrology · 2024Article
- Factors that influence the selection of conservative management for end-stage renal disease - a systematic review.Clinical kidney journal · 2024Article
- Needs of multimorbid heart failure patients and their carers: a qualitative interview study and the creation of personas as a basis for a blended collaborative care intervention.Frontiers in cardiovascular medicine · 2023Article
- Conservative Kidney Management in Kidney Transplant Populations.Seminars in nephrology · 2023Review
- Article
- An Exploratory Qualitative Study of Patient and Caregiver Perspectives of Ambulatory Kidney Palliative Care.The American journal of hospice & palliative care · 2021Article
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundOlder patients with advanced chronic kidney disease often do not understand treatment options for renal replacement therapy, conservative kidney management, and advance care planning. It is unclear whether both clinicians and patients have similar perspectives on these treatments and end-of-life care. Thus, the aim of this study was to explore clinician and patient/caregiver perceptions of treatments for end-stage renal disease and advance care planning.
methodsThis was a qualitative interview study of nephrologists (n = 8), primary care physicians (n = 8), patients (n = 10, ≥ 65 years and estimated glomerular filtration rate < 20), and their caregivers (n = 5). Interviews were conducted until thematic saturation was reached. Transcripts were transcribed using TranscribeMe. Using Nvivo 12, we identified key themes via narrative analysis.
resultsWe identified three key areas in which nephrologists', primary care physicians', and patients' expectations and/or experiences did not align: 1) dialysis discussions; 2) dialysis decision-making; and 3) processes of advance care planning. Nephrologist felt most comfortable specifically managing renal disease whereas primary care physicians felt their primary role was to advocate for patients and lead advance care planning discussions. Patients and caregivers had many concerns about the impact of dialysis on their lives and did not fully understand advance care planning. Clinicians' perspectives were aligned with each other but not with patient/caregivers.
conclusionsOur findings highlight the differences in experiences and expectations between clinicians, patients, and their caregivers regarding treatment decisions and advance care planning. Despite clinician agreement on their responsibilities, patients and caregivers were unclear about several aspects of their care. Further research is needed to test feasible models of patient-centered education and communication to ensure that all stakeholders are informed and feel engaged.
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