Palliative care in nephrology
Authors:
Barbora Szonowská
Authors‘ workplace:
Interní oddělení Strahov, Všeobecná fakultní nemocnice v Praze
Published in:
Čas. Lék. čes. 2018; 157: 25-29
Category:
Review Article
Navzdory pokroku v dialyzační technologii v průběhu posledních desetiletí mají pacienti s pokročilým chronickým onemocněním ledvin (CKD) stále vysokou zátěž symptomy, zkrácené přežívání a jsou vystaveni značnému fyzickému, emočnímu a spirituálnímu utrpení. Přibývá nemocných s pokročilým onemocněním ledvin, pro které je zahájení nebo pokračování v dialyzační léčbě spojeno s vysokým rizikem časného úmrtí nebo zhoršením funkčního stavu.
Overview
Despite the advances in dialysis technology over the past decades, patients with advanced chronic kidney disease (CKD) have a high symptom burden, shortened survival and substantial physical, emotional and spiritual suffering. Number of frailty patients with advanced chronic kidney disease is growing and for many of them the beginning or continuation of dialysis is associated with a high risk of short-term mortality or worsening of functional status.
Identifying these fragile patients and integrating palliative care into standard nephrological care improves patients’ quality of life and has the potential to prolong their lives without demanding dialysis treatment. Nephrologists’ basic skills should include: estimating the prognosis, communication with the patient on advance care planning including end-of-life issues and consistent symptom management. In fragile patients with advanced chronic kidney disease, the disease-oriented model with quantitative targets is no longer an adequate approach to care.
Keywords:
palliative/supportive care, chronic kidney disease, advance care planning, shared-decision making, conservative management, palliative dialysis, withdrawal from dialysis.
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Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric nephrology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Nephrology Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
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