End-stage kidney disease: The last 12 months.

Area of Science:

• Nephrology
• Geriatric Medicine
• Palliative Care

Background:

• Chronic kidney disease (CKD) prevalence is rising in Australia's aging population.
• Dialysis offers limited survival benefits for elderly patients with significant comorbidities and poor functional status.
• Conservative management and renal supportive care are emerging alternatives to dialysis.

Purpose of the Study:

• To outline key aspects of end-stage kidney disease (ESKD) care.
• To highlight the evolving understanding of treatment benefits in advanced kidney disease.
• To emphasize the role of general practitioners (GPs) in managing ESKD.

Main Methods:

• Review of current literature and clinical practices in nephrology and palliative care.
• Discussion of patient-centered approaches in ESKD management.
• Analysis of the trajectory of CKD and ESKD.

Main Results:

• Conservative management may be more beneficial than dialysis for select ESKD patients.
• Renal supportive care integrates palliative principles into nephrology.
• Early GP involvement is crucial throughout the CKD and ESKD patient journey.

Conclusions:

• Care for patients with ESKD requires a multidisciplinary approach.
• Prognostication and advance care planning are essential components of ESKD management.
• Integrating palliative care principles improves quality of life for patients with advanced kidney disease.