Publication:
Shared decision making in elderly patients with kidney failure

dc.contributor.coauthorBasile, Carlo
dc.contributor.coauthorBattaglia, Yuri
dc.contributor.coauthorMantovani, Alessandro
dc.contributor.coauthorPizzarelli, Francesco
dc.contributor.coauthorLuyckx, Valerie A.
dc.contributor.coauthorCovic, Adrian
dc.contributor.coauthorLiakopoulos, Vassilios
dc.contributor.coauthorMitra, Sandip
dc.contributor.coauthorEuDial Working Group of ERA
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorKanbay, Mehmet
dc.contributor.kuauthorYavuz, Furkan
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2025-01-19T10:32:01Z
dc.date.issued2023
dc.description.abstract'Elderly' is most commonly defined as an individual aged 65 years or older. However, this definition fails to account for the differences in genetics, lifestyle and overall health that contribute to significant heterogeneity among the elderly beyond chronological age. As the world population continues to age, the prevalence of chronic diseases, including chronic kidney disease (CKD), is increasing and CKD frequently progresses to kidney failure. Moreover, frailty represents a multidimensional clinical entity highly prevalent in this population, which needs to be adequately assessed to inform and support medical decisions. Selecting the optimal treatment pathway for the elderly and frail kidney failure population, be it haemodialysis, peritoneal dialysis or conservative kidney management, is complex because of the presence of comorbidities associated with low survival rates and impaired quality of life. Management of these patients should involve a multidisciplinary approach including doctors from various specialties, nurses, psychologists, dieticians and physiotherapists. Studies are mostly retrospective and observational, lacking adjustment for confounders or addressing selection and indication biases, making it difficult to use these data to guide treatment decisions. Throughout this review we discuss the difficulty of making a one-size-fits-all recommendation for the clinical needs of older patients with kidney failure. We advocate that a research agenda for optimization of the critical issues we present in this review be implemented. We recommend prospective studies that address these issues, and systematic reviews incorporating the complementary evidence of both observational and interventional studies. Furthermore, we strongly support a shared decision-making process matching evidence with patient preferences to ensure that individualized choices are made regarding dialysis vs conservative kidney management, dialysis modality and optimal vascular access.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue5
dc.description.openaccesshybrid
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipS.M. is supported by NIHR D4D MedTech Cooperative, National Institute of Health Research, UK.
dc.description.volume39
dc.identifier.doi10.1093/ndt/gfad211
dc.identifier.eissn1460-2385
dc.identifier.issn0931-0509
dc.identifier.quartileQ1
dc.identifier.scopus2-s2.0-85185918146
dc.identifier.urihttps://doi.org/10.1093/ndt/gfad211
dc.identifier.urihttps://hdl.handle.net/20.500.14288/26345
dc.identifier.wos1081418300001
dc.keywordsElderly patients
dc.keywordsFrailty
dc.keywordsHemodialysis
dc.keywordsPeritoneal dialysis
dc.keywordsVascular access
dc.language.isoeng
dc.publisherOxford Univ Press
dc.relation.grantnoS.M. is supported by NIHR D4D MedTech Cooperative, National Institute of Health Research, UK.; NIHR D4D MedTech Cooperative, National Institute of Health Research, UK
dc.relation.ispartofNephrology Dialysis Transplantation
dc.subjectMedicine
dc.titleShared decision making in elderly patients with kidney failure
dc.typeReview
dspace.entity.typePublication
local.contributor.kuauthorKanbay, Mehmet
local.contributor.kuauthorYavuz, Furkan
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine
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