[PALLIATIVE / SUPPORTIVE CARE FOR CHRONIC KIDNEY DISEASE (CKD) PATIENTS]

Patients with advanced/chronic kidney disease (CKD) stage 5 face a high burden of comorbidity, physical and mental symptoms, and impaired quality of life (QOL). Dialysis, which has become a treatment of choice, cannot supply an optimal replacement of the kidney function. Old and fragile dialysis patients with multiple comorbidities often need expensive medical treatments, repeated hospitalizations, and their life expectancy is not longer than those who have chosen not to use dialysis. The WHO emphasizes the need of palliation for serious and incurable diseases, such as CKD stage 5. Among patients who suffer from under-diagnosis and under-treatment of symptoms, some regret having started dialysis. Conservative treatment is offered only in a few cases and only a small proportion of patients have signed an Advanced Care Directive. Patients wish to receive information about their prognosis and treatment choices, thus feeling in control of their treatment. More countries are adopting the ideas of palliative care for CKD patients in order to ensure their QOL and to encourage the patients and their families to be active partners in the decision-making process. Using a palliative care approach can prevent patients from suffering and will reduce treatment costs. This review presents the data published on the subject in world literature.