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Consensus document on palliative care in cardiorenal patients
Clara Bonanad1,2,3, Juan M Buades4,5, Juan Pablo Leiva6
1Cardiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain.
Insights
This document addresses the critical need for palliative care guidelines in cardiorenal patients, offering strategies for identification, care planning, and symptom management for those with heart failure and chronic kidney disease.
Area of Science:
- Cardiology
- Nephrology
- Palliative Care
Background:
- Cardiorenal patients, with coexisting chronic heart failure and chronic kidney disease, are increasingly prevalent due to population aging.
- Existing guidelines address heart failure and kidney disease separately, lacking specific guidance for cardiorenal patients.
- There is a significant unmet need for consensus documents on managing cardiorenal patients.
Purpose of the Study:
- To establish consensus on palliative care for cardiorenal patients.
- To provide guidance on identifying cardiorenal patients and planning their shared care.
- To detail symptom management, advanced measures, dialysis considerations, and psychosocial support for this population.
Main Methods:
- Multidisciplinary expert panel collaboration.
- Review of existing guidelines for heart failure and chronic kidney disease.
- Development of recommendations for palliative care in cardiorenal patients.
Main Results:
- The document outlines a comprehensive approach to cardiorenal palliative care.
- It covers patient identification, care trajectory, symptom control, and advanced interventions.
- Considerations for dialysis and psychosocial support are included.
Conclusions:
- Consensus guidelines are essential for the effective palliative management of cardiorenal patients.
- A multidisciplinary approach is crucial for addressing the complex needs of these patients.
- This document provides a framework for improving care quality and patient outcomes.
Abstract:
There is an unmet need to create consensus documents on the management of cardiorenal patients since, due to the aging of the population and the rise of both pathologies, these patients are becoming more prevalent in daily clinical practice. Chronic kidney disease coexists in up to 40%-50% of patients with chronic heart failure cases. There have yet to be consensus documents on how to approach palliative care in cardiorenal patients. There are guidelines for patients with heart failure and chronic kidney disease separately, but they do not specifically address patients with concomitant heart failure and kidney disease. For this reason, our document includes experts from different specialties, who will not only address the justification of palliative care in cardiorenal patients but also how to identify this patient profile, the shared planning of their care, as well as knowledge of their trajectory and the palliative patient management both in the drugs that will help us control symptoms and in advanced measures. Dialysis and its different types will also be addressed, as palliative measures and when the decision to continue or not perform them could be considered. Finally, the psychosocial approach and adapted pharmacotherapy will be discussed.
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