ReviewJournal of the American Geriatrics Society2026
A Scoping Review on Decision-Making Interventions for Kidney Failure Treatment Options by the Kidney Disease Aging Research Collaborative.
Review in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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14 authors.
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Abstract
backgroundPatients with kidney disease face complex treatment decisions amid prognostic uncertainty. These decisions may be particularly challenging for older adults, who often experience cognitive and functional changes and rely on caregivers. However, limited evidence describes treatment decision-making interventions for older adults, including the decision points addressed, use of decision aids, and geriatric-relevant SDM features, including caregiver involvement, values clarification, multiple touchpoints, and prognostic information.
methodsWe conducted a scoping review of studies examining kidney failure treatment decision-making interventions that included ≥ 1 older patient(s) (≥ 65) with advanced kidney disease. We searched seven databases from inception through 4/2026. We characterized interventions by decision point, type of decision support provided, outcomes, exclusive enrollment of older adults, and presence of geriatric-relevant SDM features.
resultsWe identified 32 studies (of 2060 screened), representing 26 interventions. Seven interventions examined conservative kidney management versus dialysis, five dialysis modality, five dialysis versus transplant, and nine multiple treatment options. Among these, 11 (42%) included caregivers, 20 (77%) had multiple touchpoints, 19 (73%) included values clarification, and 12 (46%) incorporated prognostic data. Most interventions (22, 85%) incorporated decision aids. Of 137 outcomes reported, 13 (9%) were clinical. Nine interventions (35%) were evaluated exclusively among older adults.
conclusionsPatient decision aids were common in kidney failure treatment decision-making interventions, but incorporation of geriatric-relevant SDM features varied across decision points, and few interventions were evaluated exclusively among older adults. Future interventions should tailor geriatric-relevant SDM features to specific treatment decisions to best support older adults in making kidney failure treatment decisions.
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