Evidence map›Paper›PMID 40676514›Full record

ArticleBMC nephrology2025

Kidney transplantation and dialysis in older adults: goals, expectations, satisfaction, and regret - a mixed-methods prospective cohort study.

Tessa S Schoot, Marit G Zuidema, Edward Bok, Marieke Perry, Joy Lips, Femke Molenaar, Willi van Kuijk, Susan J J Logtenberg, Louis J Reichert, Bram Voorzaat and 3 more

Abstract read
In one paragraph

Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

13 authors.

Tessa S SchootDepartment of Nephrology, Radboud university medical center, Nijmegen, The Netherlands. tessa.schoot@radboudumc.nl.
Marit G ZuidemaDepartment of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Edward BokDepartment of Nephrology, Radboud university medical center, Nijmegen, The Netherlands.
Marieke PerryDepartment of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Joy LipsDepartment of Nephrology, Bernhoven, Uden, The Netherlands.
Femke MolenaarDepartment of Nephrology, Utrecht University Medical Center, Utrecht, The Netherlands.
Willi van KuijkDepartment of Nephrology, VieCuri Medical Center, Venlo, The Netherlands.
Susan J J LogtenbergDepartment of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands.
Louis J ReichertDepartment of Nephrology, Rijnstate Hospital, Arnhem, The Netherlands.
Bram VoorzaatDepartment of Nephrology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
Rob J van MarumJeroen Bosch Hospital, Department of Clinical Pharmacology, 's-Hertogenbosch, The Netherlands.
Luuk B HilbrandsDepartment of Nephrology, Radboud university medical center, Nijmegen, The Netherlands.
Angèle P M KerckhoffsDepartment of Nephrology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn older adults, decision-making about kidney failure treatments can be complex. Treatment choices should align with patient-centered goals and be guided by realistic expectations. However, limited knowledge exists regarding the goals and expectations of older patients for kidney transplantation (KT) and dialysis, as well as the extent to which these are met. This study aimed to identify the goals and expectations of older patients for KT and dialysis, to assess the achievement of these goals and expectations following KT and dialysis initiation, and to evaluate treatment satisfaction and decision regret.

methodsThis mixed-methods, prospective cohort study included KT recipients and dialysis patients aged ≥ 65 years who were suitable for KT. Qualitative data (semi-structured interviews) and quantitative data (questionnaires) were collected at baseline, and at six and 24 months after KT or dialysis initiation. Interviews were analyzed using quantitative content analyses and questionnaire data with nonparametric tests. Treatment goals and expectations for KT and dialysis were identified and categorized into medical, psychological, functional, and social domains.

resultsA total of 33 patients KT recipients and 24 dialysis patients aged ≥ 65 years participated. Treatment goals for KT and dialysis were generally fully achieved by 50-60% of patients. Patients tended to overestimate the benefits of KT and dialysis, and to underestimate the risks associated with KT. However, some benefits of KT and dialysis were not expected by patients but did occur, such as less interference with their social activities than expected. Moreover, the percentage of KT recipients who fully achieved all their treatment goals increased from 50% at six months post-KT to 90% at 24 months post-KT. Overall, treatment satisfaction was high and decision regret was low in both groups.

conclusionsThis study identified which treatment goals and expectations are realistic for adults aged ≥ 65 years who are eligible for KT. These results can be used to improve patient education programs for kidney failure therapies, and to inform shared-decision making processes regarding the choice between KT and dialysis.

Indexed as

EmotionsGoalsKidney Failure, ChronicKidney TransplantationPatient SatisfactionRenal DialysisAgedAged, 80 and overCohort StudiesDecision MakingFemaleHumansMaleProspective StudiesDecision-makingDecision regretDialysisExpectationsGeriatric nephrologyKidney transplantationOlder adultsQualitative researchTreatment goalsTreatment satisfaction

Identifiers

PMID40676514
PMCPMC12273049

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Registered trials

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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.