Assessment of competences 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.