ReviewJAMA internal medicine2025
Supporting Shared Decision-Making in Life-Altering Kidney Therapy Decisions for Older Adults: A Review.
Review in JAMA internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- ASN Kidney Health Guidance on Conservative Management in People with Kidney Failure.Journal of the American Society of Nephrology : JASN · 2026Guideline
- From "one size" to "right-fit": making goal-concordant dialysis vs. conservative kidney management operational for older adults worldwide.International urology and nephrology · 2026Article
- Predictors of Early Posttransplant Complications and Clinical Outcomes in Kidney Transplant Recipients Aged ≥65 y.Transplantation direct · 2026Article
- Older Patients and Conservative Kidney Management.JAMA network open · 2026Article
- Deciding between conservative kidney management and dialysis in older people with kidney failure: a narrative review.Clinical kidney journal · 2026Review
- Conservative kidney management in a young patient with severe intellectual disability: clinical implications for kidney therapy decision-making - a case report.BMC nephrology · 2026Article
- Comprehensive Conservative Management as Rescue Therapy After Haemodialysis Failure: Two Case Reports.Clinics and practice · 2026Article
- Kidney Transplantation in Advanced Octogenarians: The World's Oldest Kidney Transplant Recipient.Canadian journal of kidney health and disease · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Importance: Older adults represent the fastest-growing population initiating dialysis in the US. For older adults with advanced chronic kidney disease (CKD), initiating dialysis is often the default option presented, as they are often ineligible for kidney transplant. This approach may not align with many older patients' goals, who often prioritize quality of life over life extension. Further, many older patients report not being informed about all available kidney therapy options. This narrative review provides a guide for primary care clinicians to collaborate closely with older adults, their families, and nephrologists to promote shared kidney therapy decision-making in advanced CKD. Observations: Several options exist for older adults with advanced CKD. These include kidney transplant, which aims to prolong life while preserving a good quality of life; dialysis, which focuses on prolonging life; and conservative kidney management, which forgoes dialysis and transplant, prioritizing quality of life over life prolongation. Shared decision-making is a collaborative process in which clinicians and patients jointly develop a care plan based on the best available evidence, the patient's goals and prognosis, and a careful weighing of the pros and cons of each kidney therapy option. This process supports patients to achieve informed and goal-concordant decisions regarding CKD management after careful deliberation. For patients with decisional uncertainty or a desire to maintain the status quo, a time-limited trial of dialysis or a deciding not to decide approach, respectively, can be implemented. Conclusions and Relevance: Shared decision-making is essential to help older adults with advanced CKD understand therapy options and make goal-concordant decisions. Primary care clinicians' collaboration with nephrologists to promote shared decision-making and deliver patient-centered, coordinated care is critically important.
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What OpenQuestion holds
Registered trials
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.