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How do patient information documents present dialysis and conservative kidney management? A document analysis.
Ryann Sowden1, Chloe Shaw1, James Robb1
1Palliative and End of Life Care Research Group, Bristol Medical School, University of Bristol, Bristol, UK.
Clinical Kidney Journal
|June 9, 2025
Summary
Patient information on conservative kidney management (CKM) and dialysis is unbalanced, potentially influencing older adults with advanced kidney disease. Documents often omit or negatively frame CKM, impacting informed treatment choices.
Area of Science:
- Nephrology
- Geriatrics
- Health Communication
Background:
- Older adults with advanced kidney disease (AKD) face critical decisions between conservative kidney management (CKM) and dialysis.
- Patient information documents aim to clarify AKD and treatment options, supporting informed decision-making.
Purpose of the Study:
- To analyze how patient information documents portray CKM and dialysis.
- To assess the implications of this framing on patient treatment choices.
Main Methods:
- Qualitative document analysis of patient information materials from UK renal departments.
- Critical discourse analysis of collected data.
Main Results:
- Dialysis was presented as the default choice, while CKM was often omitted or negatively framed.
- CKM decision-making was depicted as challenging, with clinicians as the primary decision-makers.
- Dialysis was associated with 'living,' and CKM with 'dying,' linking CKM to end-of-life care.
Conclusions:
- Patient information documents present biased views of CKM and dialysis.
- Unbalanced framing may lead patients to overlook treatments aligning with their values.
- Accurate and balanced information is crucial for patient autonomy in AKD treatment decisions.
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