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Palliative Care for Patients with Kidney Disease
Iacopo Lanini1, Sara Samoni2, Faeq Husain-Syed3
1Department of Health Sciences, Section of Anesthesia, Intensive Care and Pain Medicine, University of Florence, 50121 Florence, Italy.
Journal of Clinical Medicine
|July 9, 2022
Summary
Palliative care, a multidisciplinary approach, can significantly benefit patients with kidney disease (CKD and AKI) by addressing their holistic needs. Early integration of palliative care, including various dialysis options, improves quality of life for these patients.
Area of Science:
- Nephrology
- Palliative Care Medicine
Background:
- Palliative care interest is growing, focusing on multidisciplinary support for patients with life-threatening illnesses.
- Despite modern concepts, palliative care is often delayed until end-of-life, leading to confusion with hospice care.
- Patients with chronic kidney disease (CKD) and acute kidney injury (AKI) often suffer poor quality of life and reduced survival, indicating a need for palliative interventions.
Purpose of the Study:
- To review the variables influencing medical decision-making for palliative care in kidney disease patients.
- To describe various palliative care approaches for CKD and AKI patients.
- To highlight the importance of early and integrated palliative care in nephrology.
Main Methods:
- Literature review of palliative care in acute kidney injury and chronic kidney disease.
- Analysis of decision-making factors in palliative care for kidney disease.
- Description of conservative management and palliative dialysis (extracorporeal and peritoneal) approaches.
Main Results:
- Palliative care requires close collaboration among healthcare providers, patients, and families for shared decision-making.
- Conservative management and peritoneal dialysis may be more suitable for frail kidney disease patients than aggressive extracorporeal dialysis.
- Individualized goal setting and a broader concept of adequacy are crucial for extracorporeal palliative dialysis.
Conclusions:
- Palliative care can address the physical, social, psychological, and spiritual needs of kidney disease patients.
- Tailored palliative strategies, including dialysis modality selection, are essential for optimizing care.
- Further research is needed, particularly for palliative and end-of-life care in acute kidney injury.
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