In the United States, elderly and frail patients with advanced chronic kidney disease (CKD) are increasingly initiated on dialytic treatments despite the little known effects on mortality and quality of life for this population. Furthermore, racial minority patients are diagnosed more frequently with advanced CKD but encounter barriers to informed dialysis decision-making and quality end-of-life care. In this two-part pilot study, the research team will first test the feasibility and acceptability of a pre-dialysis educational intervention, or COPE (Conservative Kidney Management Options and Advance Care Planning). The research team will then conduct a randomized controlled trial to determine if, compared to usual care, COPE-assigned patients have greater conservative kidney management and advance care planning knowledge and whether they're more likely to communicate preferences to family and clinicians.The study will recruit Black and White frail and elderly patients with advanced CKD in University of Pennsylvania Health System renal clinics. Findings from this study will guide researchers and clinicians in promoting informed treatment decision-making, improving advance care planning, and decreasing racial disparities in treatment knowledge and communication of care preferences among the advanced CKD population.
National Institutes of Health