A short video is changing how older kidney disease patients plan for their care. The VIDEO-KD trial found that a 12-minute video decision aid significantly boosted advance care planning documentation (56.6% vs. 40%) and helped patients move from indecision to informed treatment preferences — all without steering them toward any particular option.
For the 130,000+ Americans who start dialysis each year — often during a crisis hospitalization rather than by deliberate choice — a new tool is trying to change that story. The VIDEO-KD randomized trial tested a 12-minute video decision aid in 453 older adults (average age 78.8) with advanced chronic kidney disease (CKD), and the results were striking: patients who watched the video were far more likely to have their care preferences formally documented and to have meaningful conversations with their clinicians about treatment options.
The video, available in English and Spanish and written at a fifth-grade reading level, walks patients through hemodialysis, peritoneal dialysis, and conservative kidney management. After watching, patients recorded their personal goals and preferences — sent directly to their doctor. The approach is designed to strengthen, not replace, the patient-clinician conversation.
By the Numbers:
Why it matters: Too many patients default into dialysis during acute hospitalizations without ever expressing their own preferences. This trial shows a scalable, low-cost tool can meaningfully close that gap — giving patients a real voice in one of medicine's most consequential decisions.
