Japanese Patients’ Perceptions of Shared Decision-Making in Renal Replacement Therapy

Japanese Patients’ Perceptions of Shared Decision-Making in Renal Replacement Therapy

Introduction: Shared decision-making (SDM) is a key process in selecting renal replacement therapy (RRT). This study analyzed SDM perceptions, preferences, as well as patient- and facility-level factors influencing SDM perception among Japanese patients with chronic kidney disease (CKD) who selected...

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Main Authors: Yugo Shibagaki, Tadashi Sofue, Hiroo Kawarazaki, Tatsunori Toida, Tomo Suzuki, Hiroki Nishiwaki, Kenichiro Asano, Hiroyuki Terawaki, Takafumi Ito, Hideaki Oka, Kei Nagai, Minoru Murakami, Kojiro Nagai, Daisuke Komukai, Takayuki Adachi, Satoshi Furukata, Takaaki Tsutsui, Kiichiro Fujisaki, Seita Sugitani, Hideaki Shimizu, Tomoya Nishino, Hiroaki Asada, Hideki Shimizu, Tatsuo Tsukamoto, Izaya Nakaya, Yosuke Yamada, Ryohei Inanaga, Shohei Yamada, Shohei Nakanishi, Atsuhiro Maeda, Mari Yamamoto, Shuma Hirashio, Takeshi Okamoto, Takayuki Nakamura, Ken-ichi Miyoshi, Hiroshi Kado, Susumu Toda, Shigeru Shibata, Keiko Nishi, Makoto Yamamoto, Tsukasa Naganuma, Ryo Zamami, Masahide Furusho, Hitoshi Miyasato, Yukihiro Tamura, Yoshihiko Raita, Chisato Fukuhara, Keita Uehara, Kosuke Inoue, Yasuhiro Taki, Nobuyuki Nakano, Noriaki Kurita, Shigeyuki Arai, Tsuyoshi Watanabe, Keita Iwasaki, Yuuki Itou, Fumika Nagase, Kenta Torigoe, Shinichi Abe, Kumiko Muta, Tomomi Endo, Keita Mori, Michiya Shinozaki, Megumi Oikawa, Tsuyoshi Ohshiro, Yoshitaka Ishibashi, Ryo Sugiyama
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Kidney International Reports
Subjects:
chronic kidney disease
health care professionals
patient preferences
renal replacement therapy
shared decision-making
Online Access:http://www.sciencedirect.com/science/article/pii/S2468024925003134
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Summary:Introduction: Shared decision-making (SDM) is a key process in selecting renal replacement therapy (RRT). This study analyzed SDM perceptions, preferences, as well as patient- and facility-level factors influencing SDM perception among Japanese patients with chronic kidney disease (CKD) who selected RRT. Methods: We conducted a cross-sectional survey of 475 adult patients with CKD from 49 medical facilities. SDM awareness and recognition, preferences for SDM timing and frequency, discussion content, and desired professional involvement were assessed. Patient- and facility-level factors associated with SDM perceptions were evaluated using multivariable analysis. Results: The mean participant age was 67.4 years. Hemodialysis, peritoneal dialysis, and kidney transplantation were chosen by 71%, 24.4%, and 4.4% of patients, respectively. Although 81.2% recalled SDM occurring during RRT selection, only 4.7% were well aware of SDM before the survey. Patients prioritized discussions about daily life impact, financial burden, and family-related concerns. Most patients preferred SDM initiation when RRT was imminent, and to be conducted over multiple sessions. Many patients valued the involvement of medical social workers and their usual nonnephrologist physicians in addition to nephrologists. Multiple outpatient visits for RRT selection, involving nurse participation and extended consultation times, were significantly associated with SDM perceptions (prevalence ratio [PR]: 1.59, 95% confidence interval [CI]: 1.05–2.42). Conclusion: Many Japanese patients with CKD retrospectively evaluated RRT selection as involving SDM; however, a few were familiar with the concept beforehand. This underscores the importance of establishing systems that facilitate repeated SDM discussions at critical moments for patients. These discussions should emphasize the impact of RRT on patients’ lives and involve a multidisciplinary team.
ISSN:2468-0249

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