What this means
Patients 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.
A plain-English summary is on its way. Until then, this is the start of the authors' own summary.
- Who it was tested in
- Earlier studies
- Kind of research
- A summary of earlier studies
The science
- Original title
- A Scoping Review on Decision-Making Interventions for Kidney Failure Treatment Options by the Kidney Disease Aging Research Collaborative.
- Authors
- Clark-Cutaia MN, Mittleman I, Magro J et al.
- Journal
- Journal of the American Geriatrics Society
- Published
- Oct 19, 2026
- Study type
- Review
- PMID
- 42896980 ↗
Abstract
Background
Patients 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.
What they did
We 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.
What they found
We 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. Patient 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.
The authors' abstract, grouped under plain headings from its own section labels.
Clark-Cutaia MN, Mittleman I, Magro J et al. A Scoping Review on Decision-Making Interventions for Kidney Failure Treatment Options by the Kidney Disease Aging Research Collaborative. Journal of the American Geriatrics Society. 2026. doi:10.1111/jgs.70773. PMID: 42896980. https://pubmed.ncbi.nlm.nih.gov/42896980/