Prognostication: A Young Patient With AA Amyloidosis

Young patients and patients with multiple comorbidities often present a challenge of prognostic uncertainty. We present a case of a patient with end-stage renal failure secondary to AA amyloidosis from ongoing IV heroin use. This case presented difficulties with ethics, analgesia, prognostication, and, therefore, advanced care planning and communication challenges. These were overcome with multi-disciplinary input and careful communication with the patient and family members. The learning points include: the need for early and personalised advanced care planning, better provision of end-of-life care for patients with chaotic lifestyles and appropriate use of the ethics committee.