{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T17:34:15Z","timestamp":1787074455701,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Research Grants Council","award":["CUHK 14606222"],"award-info":[{"award-number":["CUHK 14606222"]}]},{"name":"Research Grants Council","award":["CUHK 14606222"],"award-info":[{"award-number":["CUHK 14606222"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The loss of income and surging health care expenditures exacerbate financial toxicity in patients with kidney failure undergoing dialysis.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Patients experienced financial toxicity through reduced spending, social withdrawal, negative emotions, and limited treatment options.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The study highlights the importance of addressing financial concerns in dialysis care.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many patients with kidney failure experience deteriorating financial situations that affect their everyday lives. Financial toxicity (FT) provides a person-centered perspective of this phenomenon. However, little is known about this concept in the nephrology context. This study aimed to explore the impact of FT in patients receiving dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This exploratory qualitative study purposively recruited patients on long-term dialysis on the basis of their treatment modalities and socioeconomic levels from three centers in Hong Kong. Individual semistructured interviews were conducted using an interview guide. Recordings were transcribed verbatim, and transcripts were analyzed using a thematic analysis approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-five patients were interviewed. Three themes emerged, namely, contributors, experiences, and mitigators of FT. FT was commonly triggered by decreased employment\/income and increased health care expenditures. While experiencing FT, patients often reduced their spending, avoided social activities, perceived negative thoughts and emotions, and reconsidered their treatment options. To mitigate these impacts, patients used personal resources and various assistance\/subsidy schemes. FT was more marked if the patient was unable to obtain public financial assistance. Of note, patients who were given information about the financial aspect of dialysis were better able to cope with FT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Deteriorating financial situations have multidimensional impacts on the material, psychological, and behavioral aspects of patients' lives. Although efforts are warranted to make health care systems more equitable, interventions to alleviate these impacts are not limited to monetary assistance. They can include practical support for coping with life changes and planning personal finances.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000001094","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T17:00:22Z","timestamp":1766595622000},"page":"849-858","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Impacts of Financial Toxicity on Patients Receiving Dialysis"],"prefix":"10.34067","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1520-1783","authenticated-orcid":false,"given":"Marques S.N.","family":"Ng","sequence":"first","affiliation":[{"name":"The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1968-9138","authenticated-orcid":false,"given":"Zijun","family":"Xu","sequence":"additional","affiliation":[{"name":"The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-1286","authenticated-orcid":false,"given":"Juliana N.M.","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-3959","authenticated-orcid":false,"given":"Jieling","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3921-3762","authenticated-orcid":false,"given":"Eva H.S.","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuk Ling","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5170-2027","authenticated-orcid":false,"given":"Christine","family":"Miaskowski","sequence":"additional","affiliation":[{"name":"Department of Physiological Nursing, School of Nursing, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0696-2369","authenticated-orcid":false,"given":"Carmen W.H.","family":"Chan","sequence":"additional","affiliation":[{"name":"The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9243-2924","authenticated-orcid":false,"given":"Winnie K.W.","family":"So","sequence":"additional","affiliation":[{"name":"The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"issue":"9981","key":"B1-20260430","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1016\/S0140-6736(14)61601-9","article-title":"Worldwide access to treatment for end-stage kidney disease: a systematic review","volume":"385","author":"Liyanage","year":"2015","journal-title":"Lancet."},{"issue":"2","key":"B2-20260430","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.ekir.2021.10.015","article-title":"Catastrophic health expenditure and distress financing among patients with nondialysis chronic kidney disease in Uddanam, India","volume":"7","author":"Gummidi","year":"2022","journal-title":"Kidney Int Rep."},{"issue":"4","key":"B3-20260430","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/hdi.13037","article-title":"Out-of-pocket expenditures, catastrophic household finances, and quality of life among hemodialysis patients in Kerala, India","volume":"26","author":"Valsa Jose","year":"2022","journal-title":"Hemodial Int."},{"issue":"1","key":"B4-20260430","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/hdi.12895","article-title":"Out-of-pocket payments by end-stage kidney disease patients on regular hemodialysis: cost of illness analysis, experience from Sudan","volume":"25","author":"Yousif","year":"2021","journal-title":"Hemodial Int."},{"issue":"3","key":"B5-20260430","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1053\/j.ajkd.2019.09.017","article-title":"Establishing a core outcome set for peritoneal dialysis: report of the SONG-PD (standardized outcomes in nephrology-peritoneal dialysis) consensus workshop","volume":"75","author":"Manera","year":"2020","journal-title":"Am J Kidney Dis."},{"issue":"1","key":"B6-20260430","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1053\/j.ajkd.2016.05.022","article-title":"Establishing core outcome domains in hemodialysis: report of the standardized outcomes in nephrology-hemodialysis (SONG-HD) consensus workshop","volume":"69","author":"Tong","year":"2017","journal-title":"Am J Kidney Dis."},{"issue":"2","key":"B7-20260430","doi-asserted-by":"crossref","first-page":"djw205","DOI":"10.1093\/jnci\/djw205","article-title":"Financial hardships experienced by cancer survivors: a systematic review","volume":"109","author":"Altice","year":"2017","journal-title":"J Natl Cancer Inst."},{"issue":"2","key":"B8-20260430","first-page":"80","article-title":"Financial toxicity, part I: a new name for a growing problem","volume":"27","author":"Zafar","year":"2013","journal-title":"Oncology (Williston Park)."},{"issue":"1","key":"B9-20260430","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s12913-023-10457-z","article-title":"Experience of financial toxicity and coping strategies in young and middle-aged patients with stroke: a qualitative study","volume":"24","author":"Xu","year":"2024","journal-title":"BMC Health Serv Res."},{"issue":"4","key":"B10-20260430","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.3390\/curroncol29040202","article-title":"Linking intermediate to final \u201cReal-World\u201d outcomes: is financial toxicity a reliable predictor of poorer outcomes in cancer?","volume":"29","author":"Longo","year":"2022","journal-title":"Curr Oncol."},{"issue":"2","key":"B11-20260430","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jval.2022.07.017","article-title":"Comprehensive score for financial toxicity and health-related quality of life in patients with cancer and survivors: a systematic review and meta-analysis","volume":"26","author":"Pangestu","year":"2023","journal-title":"Value Health."},{"issue":"13","key":"B12-20260430","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.2217\/fon-2021-1282","article-title":"Financial toxicity and its impact on health outcomes and caregiver burden among adult cancer survivors in the USA","volume":"18","author":"Inguva","year":"2022","journal-title":"Future Oncol."},{"issue":"18","key":"B13-20260430","doi-asserted-by":"crossref","first-page":"9541","DOI":"10.3390\/ijerph18189541","article-title":"Association between financial hardship and symptom burden in patients receiving maintenance dialysis: a systematic review","volume":"18","author":"Ng","year":"2021","journal-title":"Int J Environ Res Public Health."},{"issue":"5","key":"B14-20260430","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1053\/j.ajkd.2021.04.011","article-title":"Financial hardship among nonelderly adults with CKD in the United States","volume":"78","author":"Acquah","year":"2021","journal-title":"Am J Kidney Dis."},{"issue":"10","key":"B15-20260430","doi-asserted-by":"crossref","first-page":"4405","DOI":"10.1007\/s12325-023-02608-9","article-title":"Global economic burden associated with chronic kidney disease: a pragmatic review of medical costs for the inside CKD research programme","volume":"40","author":"Jha","year":"2023","journal-title":"Adv Ther."},{"issue":"6","key":"B17-20260430","doi-asserted-by":"crossref","first-page":"e0287510","DOI":"10.1371\/journal.pone.0287510","article-title":"Health inequity associated with financial hardship among patients with kidney failure","volume":"18","author":"Ng","year":"2023","journal-title":"PLoS One."},{"issue":"10","key":"B18-20260430","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/nep.14042","article-title":"Peritoneal dialysis first policy in Hong Kong for 35 years: global impact","volume":"27","author":"Li","year":"2022","journal-title":"Nephrology."},{"issue":"4","key":"B19-20260430","first-page":"e20220671","article-title":"Financial toxicity in people with chronic kidney disease undergoing hemodialysis treatment","volume":"76","author":"Silva","year":"2023","journal-title":"Rev Bras Enferm."},{"key":"B20-20260430","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2147\/IJNRD.S485111","article-title":"Financial toxicity and kidney disease in children and adults: a scoping review","volume":"18","author":"Siligato","year":"2025","journal-title":"Int J Nephrol Renovasc Dis."},{"issue":"6","key":"B21-20260430","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care."},{"issue":"13","key":"B22-20260430","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies:guided by information power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual Health Res."},{"issue":"4","key":"B25-20260430","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/NR9.0000000000000075","article-title":"Financial toxicity in patients with chronic kidney disease undergoing peritoneal dialysis","volume":"3","author":"Kong","year":"2024","journal-title":"Interdiscip Nurs Res."},{"issue":"1","key":"B26-20260430","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1186\/s12882-021-02552-2","article-title":"Employment of patients with kidney failure treated with dialysis or kidney transplantation\u2014a systematic review and meta-analysis","volume":"22","author":"Kirkeskov","year":"2021","journal-title":"BMC Nephrol."},{"issue":"7","key":"B27-20260430","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1093\/annonc\/mdz140","article-title":"Methods for measuring financial toxicity after cancer diagnosis and treatment: a systematic review and its implications","volume":"30","author":"Witte","year":"2019","journal-title":"Ann Oncol."},{"key":"B28-20260430","doi-asserted-by":"crossref","first-page":"1633445","DOI":"10.3389\/fpsyg.2025.1633445","article-title":"Financial toxicity and psychological distress in cardiovascular non-cancer multimorbidity: a latent profile analysis and causal weighting","volume":"16","author":"Wu","year":"2025","journal-title":"Front Psychol."},{"issue":"2","key":"B29-20260430","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.pec.2008.12.010","article-title":"A systematic review of factors influencing decision-making in adults living with chronic kidney disease","volume":"76","author":"Murray","year":"2009","journal-title":"Patient Educ Couns."},{"issue":"6","key":"B30-20260430","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1681\/ASN.2021060854","article-title":"Cost barriers to more widespread use of peritoneal dialysis in the United States","volume":"33","author":"Baerman","year":"2022","journal-title":"J Am Soc Nephrol."},{"issue":"10","key":"B31-20260430","first-page":"6109","article-title":"Identifying a cut-off score for the COST measure to indicate high financial toxicity and low quality of life among cancer patients","volume":"29","author":"Ng","year":"2021","journal-title":"Support Care Cancer."},{"issue":"10","key":"B32-20260430","doi-asserted-by":"crossref","first-page":"e223503","DOI":"10.1001\/jamahealthforum.2022.3503","article-title":"Financial incentives to facilities and clinicians treating patients with end-stage kidney disease and use of home dialysis: a randomized clinical trial","volume":"3","author":"Ji","year":"2022","journal-title":"JAMA Health Forum."},{"issue":"6","key":"B33-20260430","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1089\/pop.2021.0043","article-title":"A scoping review of behavioral interventions addressing medical financial hardship","volume":"24","author":"Patel","year":"2021","journal-title":"Popul Health Manag."},{"issue":"5","key":"B34-20260430","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1053\/j.ajkd.2019.08.005","article-title":"Dialysis care and dialysis funding in Asia","volume":"75","author":"Tang","year":"2020","journal-title":"Am J Kidney Dis."},{"issue":"7","key":"B35-20260430","first-page":"403","article-title":"Measures of financial toxicity in cancer survivors: a systematic review","volume":"32","author":"Thomy","year":"2024","journal-title":"Support Care Cancer."}],"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:56:16Z","timestamp":1786478176000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001094"}},"subtitle":["An Exploratory Qualitative Study"],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.34067\/kid.0000001094","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,24]]},"assertion":[{"value":"2025-09-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}