Family involvement and shared decision-making quality in renal replacement therapy selection: a nationwide cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Shared decision making in renal replacement therapy should reflect patient values. However, the quantitative impact of family involvement—particularly in Asian contexts—on decision-making quality remains underexplored. This nationwide, multicenter cross-sectional study (October 2022–February 2025) involved 475 adults with stage 5 chronic kidney disease across 49 facilities in Japan. Following the selection of renal replacement therapy, participants were surveyed regarding the final decision-makers and their specific roles. Shared decision-making quality was evaluated using the three-item CollaboRATE scale, assessing information exchange and preference integration. Compared with “physician-only” decisions, CollaboRATE scores (points; 95% confidence interval) were significantly higher in the “patient and physician” (+ 12.3; 1.5–23.2) and “patient, physician, and key person” groups (+ 13.7; 0.8–26.7). Role-based analyses showed that shared decision-making with the physician or key person was associated with a + 10.0 point increase (3.2–16.8) versus decisions without patient involvement. Among patients having family, scores were significantly higher for patient only (+ 9.5), patient-led with input from physician or key person (+ 10.4), and shared decision-making (+ 12.1) categories, compared with no patient involvement. Family involvement enhances shared decision-making quality when selecting renal replacement therapy, particularly when the process remains collaborative and guided by patient preferences.
Source: Scientific Reports
Authors: Yasushi Kunisho, Tadashi Sofue, Noriaki Kurita, Hiroo Kawarazaki, Tatsunori Toida, Kosuke Inoue, Hiroshi Kado, Susumu Toda, Hiroki Nishiwaki, Seita Sugitani, Izaya Nakaya, Yosuke Yamada, Makoto Yamamoto, Shigeru Shibata, Atsuhiro Maeda, Hideaki Oka, Tomoya Nishino, Tomo Suzuki, Daisuke Komukai, Masahide Furusho, Ryohei Inanaga, Keiko Nishi, Yasuhiro Taki, Hideki Shimizu, Shohei Yamada, Kenichiro Asano, Hitoshi Miyasato, Minoru Murakami, Takaaki Tsutsui, Takayuki Nakamura, Takayuki Adachi, Hiroaki Asada, Keita Uehara, Tatsuo Tsukamoto, Ryo Zamami, Yoshihiko Raita, Ken-ichi Miyoshi, Takeshi Okamoto, Takafumi Ito, Hiroyuki Terawaki, Chisato Fukuhara, Mari Yamamoto, Tsukasa Naganuma, Kei Nagai, Kojiro Nagai, Kiichiro Fujisaki, Yukihiro Tamura, Hideaki Shimizu, Shuma Hirashio, Shohei Nakanishi, Satoshi Furukata, Nobuyuki Nakano, Yugo Shibagaki, PREPARES Study Group, 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
Institutions: Kagawa University, Fukushima Medical University, Tokai University, Teikyo University Hospital, Mizonokuchi, Kyushu University of Medical Science, Omihachiman Community Medical Center, Takeda Hospital, SHOWA Medical University Fujigaoka Hospital, Japanese Red Cross Society Wakayama Medical Center, Iwate Prefectural Central Hospital, Aizawa Hospital, Chubu Rosai Hospital, Okinawa Miyako Hospital, Teikyo University, Matsuyama Red Cross Hospital, Nagasaki University Hospital, Kameda Medical Center, Kawasaki Saiwai Hospital, National Hospital Organization, Kagoshima Medical Center, Shin-yurigaoka General Hospital, Funabashi Municipal Medical Center, Daido Hospital, Japanese Red Cross Medical Center, Kurashiki Central Hospital, Okinawa Prefectural Yaeyama Hospital, Saku Central Hospital, Hidaka Hospital, Hidaka Hospital, Japan Community Healthcare Organization, Nihonmatsu Hospital, Social Medical Corporation Yuuaikai Yuuai Medical Center, Okazaki City Hospital, Naha City Hospital, Kitano Hospital, University of the Ryukyus, Okinawa Prefectural Chubu Hospital, Ehime University, Nagoya Ekisaikai Hospital, Teikyo University Chiba Medical Center, Heart Life Hospital, Yamanashi Prefectural Central Hospital, Shizuoka General Hospital, Hitachi General Hospital, Hitachi (Japan), Aso Iizuka Hospital, Osumikanoya Hospital, Hyogo Prefectural Harima-Himeji General Medical Center, Fukaya Red Cross Hospital, St. Marianna University School of Medicine
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
OpenAlex ID: W7212245278
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