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Published on: April 12, 2021
Integrating palliative care into routine nephrology practice
Judith Böhm1, Martin Windpessl2, Matthias Huemer3
1Division of Nephrology, Department of Internal Medicine VI, Municipal Hospital Klinik Ottakring of Vienna, Vienna, Austria.
Summary
Palliative care integration in nephrology is crucial for frail, elderly patients with end-stage kidney disease (ESKD). Nephrologists can use simple tools to improve symptom management and align care with patient goals, reducing interventions.
Area of Science:
- Nephrology
- Palliative Care
- Geriatrics
Background:
- Growing population of elderly and frail patients with end-stage kidney disease (ESKD).
- Increasing recognition of palliative care principles in major guidelines.
- Insufficient practical implementation of palliative care in nephrology settings.
Purpose of the Study:
- To review practical approaches for integrating palliative care in frail, elderly patients with ESKD.
- To identify actionable strategies for nephrologists to incorporate palliative care principles.
- To enhance patient-centered care and reduce burdensome interventions.
Main Methods:
- Narrative review of current evidence.
- Synthesis of practical approaches for palliative care in ESKD.
- Focus on prognostication, goals of care, conservative kidney management (CKM), dialysis individualization, deprescribing, and dialysis withdrawal.
Main Results:
- Nephrologists can implement low-threshold palliative care tools without specialist training.
- Integration of palliative care principles can reduce unnecessary interventions.
- Improved symptom management and goal-concordant care are achievable.
Conclusions:
- Palliative care integration is essential for elderly, frail ESKD patients.
- Practical, low-threshold tools empower nephrologists to provide better end-of-life care.
- Focusing on patient goals improves quality of life and reduces medical interventions.
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