[Assessment of competence of predialysis chronic kidney disease stage 5 patients to make treatment decisions: preliminary report].
The competence to consent to treatment of 26 adults with stage 5 predialysis chronic kidney disease (CKD) (16 males, 10 females, age; 58 +/- 11 years, creatinine clearance; 10.1 +/- 3.9 mL/min)was assessed using two kinds of format: the MacArthur Competence Assessment Tool-Treatment (MacCAT-T) and mini-mental-state examination (MMSE). The MacCAT-T revealed poor ability for understanding(3.72 +/- 1.11 points; perfect score, 6 points), appreciating (2.88 +/- 0.88 points; perfect score, 4 points)and reasoning(4.30 +/- 2.11 points; perfect score, 8 points). The MMSE revealed poor performance on the attentional task. The level of attentional deficit was significantly related to both poor ability for understanding and reasoning (r = 0.432, p = 0.031 and r = 0.542, p = 0.014, respectively). These results suggest that the competence of predialysis CKD stage 5 patients to consent to treatment is impaired partly via an attentional deficit.
Terawaki
Hiroyuki
H
Research Division of Dialysis and Chronic Kidney Disease, Tohoku University Graduate School of Medicine, Japan.
Sato
Toshinobu
T
Miura
Nobuyoshi
N
Saito
Keiko
K
Mifune
Naoko
N
Shoji
Wataru
W
Sato
Hironao
H
Yokota
Ayano
A
Sugiura
Akira
A
Iwabuchi
Masashi
M
Miyata
Masahiro
M
Murata
Yaeko
Y
Nakayama
Keisuke
K
Suzuki
Junpei
J
Nakamura
Masaki
M
Ito
Sadayoshi
S
Nakayama
Masaaki
M
Ueno
Takashi
T
D000368:Aged; D001288:Attention; D003956:Dialysis; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007258:Informed Consent; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales