Shared decision-making in selecting modality of renal replacement therapy confers better patient prognosis after the initiation of dialysis

Kaori Kohatsu; Shigeki Kojima; Yugo Shibagaki; Tsutomu Sakurada

doi:10.1111/1744-9987.14192

Shared decision-making in selecting modality of renal replacement therapy confers better patient prognosis after the initiation of dialysis

Ther Apher Dial. 2024 Aug 7. doi: 10.1111/1744-9987.14192. Online ahead of print.

Authors

Kaori Kohatsu¹, Shigeki Kojima¹, Yugo Shibagaki¹, Tsutomu Sakurada¹

Affiliation

¹ Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.

PMID: 39109393
DOI: 10.1111/1744-9987.14192

Abstract

Introduction: The effect of shared decision-making (SDM) regarding the choice of renal replacement therapy (RRT) for chronic kidney disease (CKD) patients on their mortality after the induction of dialysis therapy has not been adequately investigated.

Methods: Patients who initiated dialysis at our hospital were divided into two groups according to whether they participated in SDM in the outpatient clinic, and survival analysis was performed. We also examined the effect of SDM in the outpatient clinic on mortality.

Results: Of the 554 patients, 123 (22.2%) were in the SDM group. The survival rate was significantly higher in the SDM group (p = 0.001, log-rank test). Multivariate analysis excluding ADL, which competed with SDM, showed that SDM was significantly associated with mortality (HR 0.593, 95% CI: 0.353-0.997, p = 0.049).

Conclusion: SDM regarding RRT selection in the outpatient clinic may be associated with a better patient prognosis after dialysis induction.

Keywords: chronic kidney disease; multidisciplinary pre‐dialysis education; patient activation; renal replacement therapy; shared decision making.