Key result
The transition of patients with advanced CKD from predialysis to dialysis is a dynamic process shaped by personal, dialysis-related, interpersonal, community, and societal factors, requiring tailored multidisciplinary support strategies.
Why the study?
A smooth transition to dialysis is essential for survival and quality of life in patients with advanced CKD, warranting a framework to illuminate transition experiences and provide intervention strategies.
Systematic Review (n=21)
This integrative review provides a comprehensive framework for understanding the transition from predialysis to dialysis in advanced CKD, highlighting the need for tailored, multidisciplinary strategies to reduce emergency dialysis and improve patient outcomes.
Answers are grounded in this paper and cite their sources.
The CKD transition framework may inform tailored predialysis support; leaves open prospective validation before practice change.
BACKGROUND: A smooth transition to dialysis is essential for survival and quality of life in patients with advanced chronic kidney disease (CKD). OBJECTIVE: To develop a transition framework for patients with advanced CKD based on the existing research and transition theory, which aims to illuminate patients' transition experience and provide potential intervention strategies. METHODS: An integrative review methodology was employed, with searches conducted in ten Chinese and English databases (PubMed, Web of Science, CINAHL, Embase, etc.). Articles were screened and selected based on predefined criteria independently by two authors, with reference lists of included studies reviewed for further studies. Data analysis followed the approach proposed by Whittemore and Knafl. RESULTS: 13 qualitative, 7 quantitative and 1 mixed methods articles were extracted and evaluated. This review develops the transition framework for patients with advanced CKD, including the concepts of transition nature, conditions, intervention strategies, and response patterns. It provides a comprehensive understanding of how personal, dialysis-related, interpersonal, community, and societal factors shape patients' transition experiences and identifies actionable strategies to enhance transitional care. CONCLUSION: The transition of patients with advanced CKD from predialysis to dialysis is multiple and dynamic. Healthcare professionals should take into account diverse factors influencing this process and formulate tailored strategies to support patients in achieving a smooth and healthy transition. CLINICAL TRIAL NUMBER: Not applicable.
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Wang et al. (2025) conducted a systematic review in Advanced chronic kidney disease (n=21). Transitional care and predialysis education vs. Standard care or no structured transition care was evaluated. The transition of patients with advanced CKD from predialysis to dialysis is a dynamic process shaped by personal, dialysis-related, interpersonal, community, and societal factors, requiring tailored multidisciplinary support strategies.
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