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Related Concept Videos

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Related Experiment Video

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Serious Illness Conversations in advanced kidney disease: a mixed-methods implementation study.

Natanong Thamcharoen1,2, Pitchaphon Nissaisorakarn3, Robert A Cohen3

  • 1Cheewabhibaln Palliative Care Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand natthamcharoen@gmail.com.

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Summary

Advance care planning discussions using the Serious Illness Conversation Guide are acceptable for patients with advanced kidney disease. Early conversations help patients reflect on prognosis and care preferences without causing undue anxiety or hopelessness.

Keywords:
chronic conditionsclinical decisionscommunicationrenal failure

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Area of Science:

  • Nephrology
  • Palliative Care
  • Medical Ethics

Background:

  • Advanced kidney disease (AKD) carries significant morbidity and mortality risks.
  • Invasive treatments like dialysis may not always improve survival in AKD.
  • Early advance care planning (ACP) is encouraged, but its acceptability before end-stage treatment decisions is uncertain.

Purpose of the Study:

  • To explore the acceptability of using the Serious Illness Conversation Guide (SICG) for early ACP in AKD patients.
  • To evaluate the information gained from these early ACP conversations.

Main Methods:

  • Pilot mixed-methods study involving patients with advanced kidney disease (stage 3B+).
  • Semi-structured interviews utilizing an adapted SICG.
  • Thematic analysis of patient perceptions and questionnaire-based assessment of conversation acceptability.

Main Results:

  • Twenty-six patients participated; 50% were female.
  • The SICG facilitated reflection on prognosis, goals of care, and treatment preferences.
  • Most patients (88%) did not report increased anxiety, and 92% did not report decreased hopefulness.

Conclusions:

  • Patients found the adapted SICG acceptable for early ACP in advanced kidney disease.
  • The SICG can be a valuable tool for gathering patient information for future care planning in AKD.