Advance care planning for patients with end-stage kidney disease on dialysis: narrative review of the current evidence, and future considerations

Adenwalla, S. F.; O’Halloran, P.; Faull, C.; Murtagh, F. E. M.; Graham-Brown, M. P. M.

doi:10.1007/s40620-023-01841-3

Cited by 3 publications

(1 citation statement)

References 64 publications

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“…The mortality among individuals under than 75 of age old, was higher in male than in female, while the mortality among those aged 75 and the old was similar between in genders. In numerous studies, cardiovascular and cerebrovascular diseases, as well as infectious diseases, have been identi ed as the primary comorbidities associated with mortality in hemodialysis patients (2,3,7,8,(19)(20)(21). Additionally, it has been observed that vascular diseases are more prevalent among male patients in Japan (22).…”

Section: Discussionmentioning

confidence: 99%

Female patients with end-stage renal failure treated by hemodialysis had a low mortality rate and small patient number compared to male patients: 5-year follow-up study in Japan

Takagi,

Kishi,

Goto

et al. 2024

Preprint

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Background: This study aimed to evaluate gender differences in patient characteristics in maintenance hemodialysis in Takagi Hospital and, in particular, to evaluate gender differences in adverse events, gastrointestinal bleeding, and bone fractures during longitudinal follow-up period. Methods: This study included 151 patients undergoing maintenance hemodialysis for end-stage renal failure at Takagi Hospital, a regional core hospital in Japan, in December 2017. All the patients were followed up for five years or until mortality with monitoring in outpatient care. All patients were divided into a female group of 61 and a male group of 90. Patient characteristics and events were evaluated in the electronic medical record including gastrointestinal bleeding and bone fractures diagnosed and treated in Takagi Hospital. Gastrointestinal bleeding was diagnosed by endoscopy. Upper bone fractures included humeral fractures and radius fractures, and lower bone fractures were femoral neck fractures and vertebral compression fractures. Results: The patient number was small in females, which was due to the origin of renal failure with less frequency of diabetes mellitus (P < 0.02). Mortality rate was significantly less in females (P < 0.03) of younger generations less than 75 years old (P < 0.014). Multivariate analysis indicated a decrease in diabetes mellitus (odd ratio: 2.3, 95% confidence interval: 1.1-4.8, P = 0.03) and less mortality in those younger than 75 years old (odd ratio: 0.2, 95% confidence interval: 0.1-0.8, P = 0.02) were independent characterized factors in females. Regarding adverse severe events during five years, gastrointestinal bleeding and mortality due to bleeding were not different between females and males. Bone fractures were high in females (females: 34.4% vs. males: 18.9%; P < 0.03), whereas the mortality rate of bone fractured patients was markedly high in males (females: 28.6% vs males: 76.5%; P = 0.003). The increase in mortality rate in males was in patients with lower body bone fractures (P = 0.006). Conclusions: Diabetes mellitus-induced end-stage renal failure was less common in females. The mortality rate during hemodialysis was lower in females, especially in patients less than 75 years old. Lower body bone fractures exacerbated mortality more frequently in males compared to females.

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Section: Discussionmentioning

confidence: 99%

Female patients with end-stage renal failure treated by hemodialysis had a low mortality rate and small patient number compared to male patients: 5-year follow-up study in Japan

Takagi,

Kishi,

Goto

et al. 2024

Preprint

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Preferences for Advance Care Planning in Patients with End-Stage Kidney Disease: A Cross-Sectional Survey among Nephrology Healthcare Providers in a Tertiary Care Center in India

Naik,

Ghoshal,

Damani

et al. 2024

Nephron

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Introduction: Advance care planning (ACP) is essential in managing patients with end-stage kidney disease (ESKD), yet its integration into clinical practice remains limited, particularly in low- and middle-income countries. This study explores the preferences, attitudes and perceived barriers of nephrology healthcare providers toward ACP for patients with ESKD in a tertiary care center in India. Methods: A cross-sectional survey was conducted among nephrology healthcare providers at a tertiary care center in India. The survey, developed from literature reviews and pretested, covered demographics, ACP knowledge and attitudes, current practices, and perceived barriers and facilitators. Data collection occurred from September 2022 to March 2023. Quantitative data were analyzed descriptively, and qualitative data through thematic analysis. Results: A total of 50 healthcare providers participated. While 36% acknowledged the importance of ACP, only 8% routinely engaged in ACP discussions. Major barriers included inadequate training (22%), lack of awareness about the importance of discussing ACP among stakeholders (20%), cultural barriers (18%), lack of time (14%), and the absence of institutional protocols for discussion on ACP (14%). Additional barriers included instances where families withhold health information from patients due to fear of losing hope (16%) and patient/family discomfort in discussing ACP (12%). Providers expressed a need for structured ACP protocols and educational programs. Conclusion: Despite recognizing its importance, ACP is underutilized in the care of patients with ESKD in India. Addressing the identified barriers through targeted interventions may enhance ACP practices and improve patient outcomes.

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Female patients with end-stage renal failure treated by hemodialysis had a low mortality rate and small patient number compared to male patients: 5-year follow-up study in Japan

Takagi,

Kishi,

Goto

et al. 2024

J. Clin. Biochem. Nutr.

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This study aimed to evaluate gender differences of hemodialysis patients in adverse events, gastrointestinal bleeding, and bone fractures during 5 year longitudinal follow-up period in the regional core hospital in Japan. This study included 151 patients with maintenance hemodialysis for end-stage renal failure at Takagi Hospital in December 2017. All the patients, divided into females-group of 61 and males-group of 90. Data were evaluated in the electronic medical record. Multivariate analysis indicated a decrease in diabetes mellitus (odd ratio: 2.3, 95% confidence interval: 1.1–4.8, p = 0.03) and less mortality in those younger than 75 years old (odd ratio: 0.2, 95% confidence interval: 0.1–0.8, p = 0.02) were characterized factors in females. Gastrointestinal bleeding were not different between genders. Bone fractures were high in females (females: 34.4% vs males: 18.9%; p <0.03), whereas the mortality rate of bone fractured patients was markedly high in males (females: 28.6% vs males: 76.5%; p = 0.003) with lower body bone fractures. In conclusion, diabetes mellitus-induced end-stage renal failure was less common in females. The mortality rate during hemodialysis was higher in males less than 75 years old with increased mortality with lower bone fractures.

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Advance care planning for patients with end-stage kidney disease on dialysis: narrative review of the current evidence, and future considerations

Cited by 3 publications

References 64 publications

Female patients with end-stage renal failure treated by hemodialysis had a low mortality rate and small patient number compared to male patients: 5-year follow-up study in Japan

Female patients with end-stage renal failure treated by hemodialysis had a low mortality rate and small patient number compared to male patients: 5-year follow-up study in Japan

Preferences for Advance Care Planning in Patients with End-Stage Kidney Disease: A Cross-Sectional Survey among Nephrology Healthcare Providers in a Tertiary Care Center in India

Female patients with end-stage renal failure treated by hemodialysis had a low mortality rate and small patient number compared to male patients: 5-year follow-up study in Japan

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