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

Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy Pub Date : 2025-02-01 Epub Date: 2024-08-07 DOI:10.1111/1744-9987.14192

Kaori Kohatsu, Shigeki Kojima, Yugo Shibagaki, Tsutomu Sakurada

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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.

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共同决策选择肾脏替代疗法的方式可使患者在开始透析后获得更好的预后。

简介：关于慢性肾脏病（CKD）患者选择肾脏替代疗法（RRT）的共同决策（SDM）对其开始透析治疗后死亡率的影响尚未得到充分研究：方法：将在我院开始透析治疗的患者按照是否在门诊参与 SDM 分成两组，并进行生存分析。我们还研究了门诊 SDM 对死亡率的影响：在 554 名患者中，SDM 组有 123 人（22.2%）。SDM 组的存活率明显更高（p = 0.001，log-rank 检验）。排除与 SDM 竞争的 ADL 后进行的多变量分析表明，SDM 与死亡率显著相关（HR 0.593，95% CI：0.353-0.997，p = 0.049）：结论：门诊中关于 RRT 选择的 SDM 可能与透析诱导后患者预后的改善有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy

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