Abstract：
BACKGROUND: The effect of shared decision-making (SDM) regarding the choice of renal replacement therapy (RRT) for chronic kidney disease (CKD) patients on their mortality after the induction of dialysis therapy has not been adequately investigated.
METHODS: Patients who initiated dialysis at our hospital were divided into two groups according to whether they participated in SDM in the outpatient clinic, and survival analysis was performed. We also examined the effect of SDM in the outpatient clinic on mortality.
RESULTS: Of the 554 patients, 123 (22.2%) were in the SDM group. The survival rate was significantly higher in the SDM group (p = 0.001, log-rank test). Multivariate analysis excluding ADL, which competed with SDM, showed that SDM was significantly associated with mortality (HR 0.593, 95% CI: 0.353-0.997, p = 0.049).
CONCLUSIONS: SDM regarding RRT selection in the outpatient clinic may be associated with a better patient prognosis after dialysis induction.
METHODS: Patients who initiated dialysis at our hospital were divided into two groups according to whether they participated in SDM in the outpatient clinic, and survival analysis was performed. We also examined the effect of SDM in the outpatient clinic on mortality.
RESULTS: Of the 554 patients, 123 (22.2%) were in the SDM group. The survival rate was significantly higher in the SDM group (p = 0.001, log-rank test). Multivariate analysis excluding ADL, which competed with SDM, showed that SDM was significantly associated with mortality (HR 0.593, 95% CI: 0.353-0.997, p = 0.049).
CONCLUSIONS: SDM regarding RRT selection in the outpatient clinic may be associated with a better patient prognosis after dialysis induction.
摘要：
背景：关于慢性肾脏病（CKD）患者选择肾脏替代治疗（RRT）的共同决策（SDM）对诱导透析治疗后死亡率的影响尚未得到充分研究。
方法：在我院开始透析的患者根据是否参加门诊SDM分为两组，并进行生存分析。我们还检查了门诊中SDM对死亡率的影响。
结果：在554名患者中，123人(22.2%)在SDM组中。SDM组的生存率明显更高（p=0.001，对数秩检验）。不包括ADL的多变量分析，与SDM竞争，结果显示SDM与死亡率显著相关(HR0.593,95%CI:0.353-0.997,p=0.049)。
结论：关于在门诊选择RRT的SDM可能与透析诱导后更好的患者预后相关。
方法：在我院开始透析的患者根据是否参加门诊SDM分为两组，并进行生存分析。我们还检查了门诊中SDM对死亡率的影响。
结果：在554名患者中，123人(22.2%)在SDM组中。SDM组的生存率明显更高（p=0.001，对数秩检验）。不包括ADL的多变量分析，与SDM竞争，结果显示SDM与死亡率显著相关(HR0.593,95%CI:0.353-0.997,p=0.049)。
结论：关于在门诊选择RRT的SDM可能与透析诱导后更好的患者预后相关。
