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Delivering palliative and end-of-life care to patients undergoing peritoneal dialysis: Your questions answered
Ismay N van Loon1,2, Sarbjit V Jassal1,3
1Division of Nephrology, University Health Network, Toronto, ON, Canada.
Abstract:
Increasingly, nephrologists struggle with providing care to patients with complex diseases who are heading towards the end of life. In this vignette, we illustrate how to recognize and acknowledge disease progression, tailor treatments to frailty status, and extend high-quality kidney care through to the time of death. Questions answered include how to discuss prognosis while retaining feelings of hope, and tips on how to recognize that the end-of-life may be approaching are included as part of the case discussion. We advocate for modest changes to nephrology care guidelines that promote integration of both high clinical standards and holistic and practical kidney care.
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Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Dialysis

