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Kidney Supportive Care: Core Curriculum 2020
Samantha L Gelfand1, Jennifer S Scherer2, Holly M Koncicki3
1Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA.
Summary
Kidney supportive care integrates palliative medicine for kidney disease patients, focusing on symptom relief and psychosocial support. It enhances care through nephrology teams and interprofessional collaboration for better patient outcomes.
Area of Science:
- Nephrology
- Palliative Medicine
- Symptom Management
Background:
- Kidney disease impacts patients significantly, necessitating specialized care beyond disease management.
- Palliative care principles are crucial for alleviating suffering in kidney patients.
Purpose of the Study:
- To outline practical applications of kidney supportive care.
- To emphasize the nephrologist's role in symptom management and conservative care.
- To discuss supportive care for acute kidney injury and end-of-life decisions.
Main Methods:
- Integration of palliative medicine principles into nephrology practice.
- Primary palliative care by nephrology teams.
- Comanagement with interprofessional specialty palliative care teams.
Main Results:
- Kidney supportive care addresses symptoms and psychosocial distress.
- It supports patients with acute kidney injury, chronic kidney disease, and kidney failure.
- Care extends beyond end-of-life, encompassing dialysis withdrawal and conservative management.
Conclusions:
- Kidney supportive care is essential for comprehensive patient management.
- Collaboration between nephrology and palliative care teams improves patient and family support.
- This approach enhances quality of life for individuals with kidney disease.
Keywords:
Kidney supportive care/renal supportive care/palliative careconservative care/comprehensive conservative care/active medical management/maximal medical managementdialysis withdrawal/withholding dialysis/stopping dialysisend-of-life decision makingshared decision-making/informed consent/patient-centered care/prognostic awarenesssymptom management/symptom burden