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Related Concept Videos

Regression Toward the Mean01:52

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...
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Decision Making

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Reason and Intuition

The human brain processes information for decision-making using one of two routes: an intuitive system and a rational system (Epstein, 1994; popularized by Kahneman, 2011 as System 1 and System 2, respectively). The intuitive system is quick, impulsive, and operates with minimal effort, relying on emotions or habits to provide cues for what to do next, while the rational system is logical, analytical, deliberate, and methodical. Research in neuropsychology suggests that the brain can only use...
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Constrained by limited energy and resources, organisms must compromise between offspring quantity and parental investment. This trade-off is represented by two primary reproductive strategies; K-strategists produce few offspring but provide substantial parental support, whereas r-strategists produce much progeny that receives little care. These strategies are related to an organism’s survival likelihood across its lifespan, which is represented by a survivorship curve. Three general types of...

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Errors as a Means of Reducing Impulsive Food Choice
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Published on: June 5, 2016

Temporal Trends in Decisions to Forgo KRT.

Susan P Y Wong1,2, Lindsey M Kornowske3, Cami R Jones3

  • 1Division of Nephrology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Kidney360
|June 5, 2026
PubMed
Summary

Forgoing kidney replacement therapy (KRT) is uncommon, with most patients with kidney failure receiving or preparing for KRT. This trend remained stable over the past decade, indicating KRT

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Area of Science:

  • Nephrology
  • Public Health
  • Geriatrics

Background:

  • Dialysis initiation rates have declined after years of increase.
  • Conservative kidney management is a growing alternative to dialysis.
  • Understanding trends in patients forgoing dialysis is crucial.

Purpose of the Study:

  • To investigate contemporary trends in treatment decisions for advanced kidney disease.
  • To analyze the proportion of patients opting for or against kidney replacement therapy (KRT).
  • To examine these trends across different age groups and time periods.

Main Methods:

  • Retrospective cohort study of adults with advanced kidney disease (eGFR ≤15 mL/min/1.73m2).
  • Analysis of data from a large US health system between 2012-2020.
  • Review of administrative codes and clinical notes to determine KRT decisions.

Main Results:

  • 90% of patients received KRT, while 6% decided against it.
  • Treatment decisions for KRT remained stable over the study period (2012-2020).
  • No significant changes in KRT decisions were observed across different age groups.

Conclusions:

  • Forgoing KRT is infrequent among patients with advanced kidney disease.
  • KRT remains the predominant approach for kidney failure care.
  • The default approach to kidney failure care has largely remained consistent over the last decade.