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Renal Conservative and Palliative Care

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290 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Fahad Saeed, Dale Lupu, Alvin H Moss
No abstract text is available yet for this article.
December 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Brendan P Cassidy, Leah E Getchell, Lori Harwood, Juliya Hemmett, Louise M Moist
Purpose of review: Provision of education to inform decision making for renal replacement therapy (RRT) is a key component in the management of chronic kidney disease (CKD), yet patients report suboptimal satisfaction with the process of selecting a dialysis modality. Our purpose is to review the influencers of RRT decision making in the CKD population, which will better inform the process of shared decision making between clinicians and patients. Sources of information: PubMed and Google Scholar...
2018: Canadian Journal of Kidney Health and Disease
Julia Thumfart, Dirk Bethe, Sarah Wagner, Wolfgang Pommer, Cornelia Rheinländer, Dominik Müller
AIM: Children and adolescents with end stage renal disease face a high morbidity and mortality. Palliative care provides a multidisciplinary approach to reduce disease burden and improve quality of life. This study evaluated concepts and current structures of palliative care from the perspective of a multidisciplinary paediatric nephrology team including physicians, nurses and psychosocial health professionals. METHODS: Evaluation was done by an online survey sent to the members of the German Society of Nephrology and to the nurse managers of German paediatric dialysis centres between April 9th 2018 and May 31th 2018...
December 11, 2018: Acta Paediatrica
Nancy Armistead, Renee Bova-Collis
Advance directives ensure that an individual's wishes for health care are honored. Only about one-half of dialysis patients have advance directives, and less than 10% of patients have had discussions about end-of-life care with their physicians. The Coalition for Supportive Care of Kidney Patients interviewed patients regarding their experience completing advance directives. Themes identified included a precipitating health care crisis, the experience of decision-making for others, and availability of advance directive information...
October 2016: Nephrology News & Issues
The Lancet
No abstract text is available yet for this article.
October 27, 2018: Lancet
Tyrone G Harrison, Helen Tam-Tham, Brenda R Hemmelgarn, Matthew T James, Aynharan Sinnarajah, Chandra M Thomas
RATIONALE & OBJECTIVE: Conservative kidney management is holistic patient-centered care for patients with kidney failure that focuses on delaying the progression of kidney disease and symptom management, without the provision of renal replacement therapy. Currently there is no consensus as to what constitutes high-quality conservative kidney management. We aimed to develop a set of quality indicators for the conservative management of kidney failure. STUDY DESIGN: Nominal group technique and Delphi survey process...
October 25, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Amar D Bansal, Jane O Schell
No abstract text is available yet for this article.
November 23, 2018: Nephrology, Dialysis, Transplantation
Rebecca L Sudore
No abstract text is available yet for this article.
November 26, 2018: JAMA Internal Medicine
Fareed B Kamar, Helen Tam-Tham, Chandra Thomas
BACKGROUND: Conservative/palliative (nondialysis) management is an option for some individuals for treatment of stage 5 chronic kidney disease (CKD). Little is known about these individuals treated with conservative care in the Canadian setting. OBJECTIVE: To describe the characteristics of patients treated with conservative care for category G5 non-dialysis CKD in a Canadian context. DESIGN: Retrospective chart review. SETTING: Urban nephrology center...
2017: Canadian Journal of Kidney Health and Disease
Sana Akbar, Alvin H Moss
Older patients are more susceptible to AKI. In the elderly, AKI has been associated with increased morbidity and mortality, and it is a significant risk factor for CKD and dialysis-dependent ESRD. There are now accumulating data that the start of dialysis for some older patients is associated with poor outcomes, such as high treatment intensity, suffering, and limited life prolongation, which occur at the expense of dignity and quality of life. The biomedicalization of aging is a relatively recent field of ethical inquiry with two directly relevant features to decisions about starting dialysis for older patients with AKI: (1) the routinization of geriatric clinical interventions, such as dialysis, which results in the overshadowing of patient choice, and (2) the transformation of the technological imperative into the moral imperative...
September 5, 2014: Clinical Journal of the American Society of Nephrology: CJASN
Jemima Scott, Amanda Owen-Smith, Sarah Tonkin-Crine, Hugh Rayner, Paul Roderick, Ikumi Okamoto, Geraldine Leydon, Fergus Caskey, Shona Methven
OBJECTIVE: To explore dialysis decision-making for adults who lack capacity due to cognitive impairment, a common and under-recognised condition in those with advanced chronic kidney disease (CKD). DESIGN: Secondary analysis of qualitative data collected during the Conservative Kidney Management Assessment of Practice Patterns Study programme of research was performed. Sixty semistructured interviews were conducted with multiprofessional team members from UK renal centres...
November 12, 2018: BMJ Open
Rebecca L Sudore, Dean Schillinger, Mary T Katen, Ying Shi, W John Boscardin, Stacy Osua, Deborah E Barnes
Importance: Advance care planning improves the receipt of medical care aligned with patients' values; however, it remains suboptimal among diverse patient populations. To mitigate literacy, cultural, and language barriers to advance care planning, easy-to-read advance directives and a patient-directed, online advance care planning program called PREPARE For Your Care (PREPARE) were created in English and Spanish. Objective: To compare the efficacy of PREPARE plus an easy-to-read advance directive with an advance directive alone to increase advance care planning documentation and patient-reported engagement...
October 29, 2018: JAMA Internal Medicine
Maharajan Raman, Rachel J Middleton, Philip A Kalra, Darren Green
BACKGROUND: The benefits of dialysis in older people with ESKD are not clear. We prospectively evaluated whether dialysis has survival advantage compared to conservative care (CC) in older people who were medically suitable for dialysis therapy. METHODS: This was a prospective observational study of CKD patients aged ≥75 years when eGFR first reached ≤15ml/min/1.73m2. Hazard ratios (HR) for death were compared between patients who chose dialysis versus conservative care (CC) from when first seen in pre-dialysis clinic (eGFR ≤15ml/min/1...
2018: PloS One
Shehryar Khan, Lauren Wake, Kristina Glover, Pedro Bauza, Deepak Prabhakar, Esther Akinyemi
No abstract text is available yet for this article.
October 25, 2018: Hemodialysis International
Manuel Heras Benito, María José Fernández-Reyes Luis
Chronic kidney disease is common in people >65years of age. The development and improvement of dialysis techniques has allowed its generalisation to the entire population, when there is a situation of terminal nephropathy, without limit of use due to chronological age. Decision making in elderly patients with advanced chronic kidney disease is complex: in addition to renal parameters, both comorbidity and the presence of geriatric syndromes must be considered. This review addresses the management of information, the decision making of different treatment modalities that can be offered to these patients, and the time of initiation and/or withdrawal of dialysis...
October 17, 2018: Medicina Clínica
Séamus Coyle, Jo Elverson, Tim Harlow, Alice Jordan, Paul McNamara, Catherine O'Neill, Rachel Quibell, Claud Regnard, Juliet Spiller, Jeff Stephenson
No abstract text is available yet for this article.
October 6, 2018: Lancet
Elizabeth Anderson, Annette Aldous, Dale Lupu
Advance care planning for persons with chronic kidney disease is under-utilized despite evidence it can improve care at the end of life. Motivational interviewing and Stages of Change Theory can help healthcare professionals elicit behavior change. This article outlines an approach to advance care planning using motivational interviewing with a healthcare coach to assist patients in expressing their unique values and wishes regarding care at the end of life. This Make Your Wishes About You (MY WAY) approach to advance care planning for patients with chronic kidney disease includes patient education material and a coach training curriculum freely available from the Coalition for Supportive Care of Kidney Patients...
September 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Richard E Leiter, Miryam Yusufov, Mohammad Adrian Hasdianda, Lauren A Fellion, Audrey C Reust, Susan D Block, James A Tulsky, Kei Ouchi
CONTEXT: Emergency department (ED) visits provide opportunities to empower patients to discuss advance care planning with their outpatient clinicians, but systematically developed, feasible interventions do not currently exist. Brief negotiated interview (BNI) interventions, which allow ED clinicians to efficiently motivate patients, have potential to meet this need. OBJECTIVES: We developed a BNI ED intervention to empower older adults with life-limiting illness to formulate and communicate medical care goals to their primary outpatient clinicians...
September 14, 2018: Journal of Pain and Symptom Management
Cherie Kapell Brown, Jennifer Kryworuchko, Wanda Martin
BACKGROUND: People with end stage renal disease (ESRD) face important health-related decisions concerning end-of-life care and the use of life-support technologies. While people often want to be involved in making decisions about their health, there are many challenges. People with advanced illness may have limited or wavering ability to participate fully in decision-making conversations - or lack decisional capacity for making decisions. Additionally, they may have a limited understanding of CPR and tend to receive inconsistent information on the process and outcome of CPR...
September 12, 2018: BMC Nephrology
Kirsten L Johansen, Cynthia Delgado, George A Kaysen, Glenn M Chertow, Janet Chiang, Lorien S Dalrymple, Mark R Segal, Barbara A Grimes
Background: Understanding how components of frailty change over time and how they can be modeled as time-dependent predictors of mortality could lead to better risk prediction in the dialysis population. Methods: We measured frailty at baseline, 12, and 24 months among 727 patients receiving hemodialysis in Northern California and Atlanta. We examined the likelihood of meeting frailty components (weight loss, exhaustion, low physical activity, weak grip strength, and slow gait speed) as a function of time in logistic regression analysis and association of frailty components with mortality in time-updated multivariable Cox models...
September 5, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
2018-09-11 11:22:47
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