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Renal Palliative Care

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220 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29331475/end-of-life-care-for-patients-with-advanced-kidney-disease-in-the-us-veterans-affairs-health-care-system-2000-2011
#1
Susan P Y Wong, Margaret K Yu, Pamela K Green, Chuan-Fen Liu, Paul L Hebert, Ann M O'Hare
BACKGROUND: Little is known about patterns of end-of-life care for patients with advanced kidney disease not treated with maintenance dialysis. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: A sample of 14,071 patients with sustained estimated glomerular filtration rates < 15mL/min/1.73m2 treated in the US Veterans Affairs health care system who died during 2000 to 2011. Before death, 12,756 of these patients had been treated with dialysis, 503 had been discussing and/or preparing for dialysis therapy, and for 812, there had been a decision not to pursue dialysis therapy...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29331476/factors-associated-with-withdrawal-from-maintenance-dialysis-a-case-control-analysis
#2
James B Wetmore, Heng Yan, Yan Hu, David T Gilbertson, Jiannong Liu
BACKGROUND: Little is known about differences in the clinical course between patients receiving maintenance dialysis who do and do not withdraw from dialysis therapy. STUDY DESIGN: Case-control analysis. SETTING & PARTICIPANTS: US patients with Medicare coverage who received maintenance hemodialysis for 1 year or longer in 2008 through 2011. PREDICTORS: Comorbid conditions, hospitalizations, skilled nursing facility stays, and a morbidity score based on durable medical equipment claims...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28852478/an-end-of-life-practice-survey-among-clinical-nephrologists-associated-with-a-single-nephrology-fellowship-training-program
#3
Kevin A Ceckowski, Dustin J Little, Joseph R Merighi, Teri Browne, Christina M Yuan
BACKGROUND: Our nephrology fellowship requires specific training in recognition and referral of end-stage renal disease patients likely to benefit from palliative and hospice care. METHODS: To identify end-of-life (EOL) referral barriers that require greater training emphasis, we performed a cross-sectional, 17-item anonymous online survey (August-October 2015) of 93 nephrologists associated with the program since 1987. RESULTS: There was a 61% response rate (57/93 surveys)...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#4
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29227577/management-of-pain-in-end-stage-renal-disease-patients-short-review
#5
REVIEW
Rupesh Raina, Vinod Krishnappa, Mona Gupta
Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29220099/supportive-palliative-care-should-be-integrated-into-routine-care-for-paediatric-patients-with-life-limiting-kidney-disease
#6
REVIEW
Julia Thumfart, Tobias Reindl, Cornelia Rheinlaender, Dominik Müller
Paediatric palliative care is no longer restricted to patients with cancer and has been extended to patients with other chronic conditions, such as cystic fibrosis or neuromuscular disorders. This review focused on the current state of palliative care for children and adolescents with chronic kidney disease (CKD). We assessed the literature on CKD published up to August 2017. All the papers, except one from 1996, were published this century. This review discusses the role that palliative care plays in the process of decision-making and explores the possibilities of implementing palliative care into the routine therapy of affected patients and providing support for their families...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28976070/palliative-and-end-of-life-care-in-solid-organ-transplantation
#7
REVIEW
K Wentlandt, A Weiss, E O'Connor, E Kaya
Palliative care is an interprofessional approach that focuses on quality of life of patients who are facing life-threatening illness. Palliative care is consistently associated with improvements in advance care planning, patient and caregiver satisfaction, quality of life, symptom burden, and lower healthcare utilization. Most transplant patients have advanced chronic disease, significant symptom burden, and mortality awaiting transplant. Transplantation introduces new risks including perioperative death, organ rejection, infection, renal insufficiency, and malignancy...
December 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29159371/care-planning-for-inpatients-referred-for-palliative-care-consultation
#8
Kara Bischoff, David L O'Riordan, Angela K Marks, Rebecca Sudore, Steven Z Pantilat
Importance: Care planning is a critical function of palliative care teams, but the impact of advance care planning and goals of care discussions by palliative care teams has not been well characterized. Objective: To describe the population of patients referred to inpatient palliative care consultation teams for care planning, the needs identified by palliative care clinicians, the care planning activities that occur, and the results of these activities. Design, Setting, and Participants: This was a prospective cohort study conducted between January 1, 2013, and December 31, 2016...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29130949/performance-of-the-surprise-question-compared-to-prediction-models-in-hemodialysis-patients-a-prospective-study
#9
Rakesh Malhotra, Xia Tao, Yuedong Wang, Yuqi Chen, Rebecca H Apruzzese, Paul Balter, Qingqing Xiao, Len A Usvyat, Peter Kotanko, Stephan Thijssen
BACKGROUND: The surprise question (SQ) ("Would you be surprised if this patient were still alive in 6 or 12 months?") is used as a mortality prognostication tool in hemodialysis (HD) patients. We compared the performance of the SQ with that of prediction models (PMs) for 6- and 12-month mortality prediction. METHODS: Demographic, clinical, laboratory, and dialysis treatment indicators were used to model 6- and 12-month mortality probability in a HD patients training cohort (n = 6,633) using generalized linear models (GLMs)...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29132161/a-research-agenda-for-high-value-palliative-care
#10
Katherine R Courtright, J Brian Cassel, Scott D Halpern
No abstract text is available yet for this article.
January 2, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29131496/suboptimal-initiation-predicts-short-term-prognosis-and-vulnerability-among-very-elderly-patients-who-start-hemodialysis
#11
Atsuhiro Kanno, Masaaki Nakayama, Satoru Sanada, Mitsuhiro Sato, Toshinobu Sato, Yoshio Taguma
AIM: A recent, growing concern regarding hemodialysis in Japan is a sustained increase in the elderly population. Among very elderly people who start hemodialysis, the prognosis is considered to be poor; however, this has not been fully elucidated. This study aimed to discover the short-term prognosis and related factors in very elderly patients who commence hemodialysis. METHODS: Between January 2008 and December 2013, 122 patients aged ≥85 years at hemodialysis initiation were documented in our hospital...
November 13, 2017: Nephrology
https://www.readbyqxmd.com/read/29132946/an-interview-study-of-patient-and-caregiver-perspectives-on-advance-care-planning-in-esrd
#12
Marcus Sellars, Josephine M Clayton, Rachael L Morton, Tim Luckett, William Silvester, Lucy Spencer, Carol A Pollock, Rowan G Walker, Peter G Kerr, Allison Tong
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, it can be an emotionally charged process for patients with kidney disease and their caregivers. This study aimed to describe the perspectives and attitudes of patients with end-stage renal disease (ESRD) and their caregivers toward ACP. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Patients with ESRD (n=24) and their caregivers (n=15) aged 36 to 91 years at various stages of ACP ("not commenced," "in progress," or "completed") from 3 renal services...
November 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29055351/palliative-nephrology-time-for-new-insights
#13
EDITORIAL
Emma Murphy, Michael J Germain, Fliss Murtagh
No abstract text is available yet for this article.
November 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29032993/alleviating-the-access-abyss-in-palliative-care-and-pain-relief-an-imperative-of-universal-health-coverage-the-lancet-commission-report
#14
REVIEW
Felicia Marie Knaul, Paul E Farmer, Eric L Krakauer, Liliana De Lima, Afsan Bhadelia, Xiaoxiao Jiang Kwete, Héctor Arreola-Ornelas, Octavio Gómez-Dantés, Natalia M Rodriguez, George A O Alleyne, Stephen R Connor, David J Hunter, Diederik Lohman, Lukas Radbruch, María Del Rocío Sáenz Madrigal, Rifat Atun, Kathleen M Foley, Julio Frenk, Dean T Jamison, M R Rajagopal
No abstract text is available yet for this article.
October 11, 2017: Lancet
https://www.readbyqxmd.com/read/29042462/infrequent-provision-of-palliative-care-to-patients-with-dialysis-requiring-aki
#15
Kelly Chong, Samuel A Silver, Jin Long, Yuanchao Zheng, V Shane Pankratz, Mark L Unruh, Glenn M Chertow
BACKGROUND AND OBJECTIVES: The use of palliative care in AKI is not well described. We sought to better understand palliative care practice patterns for hospitalized patients with AKI requiring dialysis in the United States. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using the 2012 National Inpatient Sample, we identified patients with AKI and palliative care encounters using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29044340/renouncement-of-renal-replacement-therapy-withdrawal-and-refusal
#16
José Andrade Moura, Ana Flávia de Souza Moura, José Hermógenes Rocco Suassuna
Renouncement of renal replacement therapy (RRT) is a medical dilemma. This review covers the concept, the magnitude, the prognosis, and discusses strategies and management approaches about this subject in patients with CKD and AKI. Evidence suggests that refusal is more frequent and carries a more guarded prognosis than withdrawal of RRT. When RRT is not expected to be beneficial in terms of survival or quality of life, conservative treatment and palliative care are alternatives. We review the historical evolution of guidelines about renouncement of RRT and palliative care, and highlight the absence of specific recommendations in Brazil...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28985192/incorporating-supportive-care-into-the-hemodialysis-unit
#17
Rebecca J Schmidt
PURPOSE OF REVIEW: Advance care planning is underutilized in patients with dialysis-dependent kidney failure and the provision of high intensity rather than supportive care is a standard practice in most hemodialysis units wherever challenges to incorporating palliative or supportive care into unit processes remain formidable. RECENT FINDINGS: The practice of advance care planning empowers patients, families and physicians and drives decisions about future treatment that align with patients' values, wishes and changing clinical circumstances...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28967963/use-of-a-questionnaire-to-initiate-advance-care-planning-discussions-in-dialysis-patients
#18
Willem Jan W Bos, Wouter R Verberne
No abstract text is available yet for this article.
October 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28967968/usefulness-of-questionnaires-on-advance-directives-in-haemodialysis-units
#19
Angel Rodríguez Jornet, Loreley Ana Betancourt Castellanos, Maria Isabel Bolós Contador, Juan Carlos Oliva Morera, José Antonio Ibeas López
Background: As renal replacement therapy has become universal practice in medicine, there is a need to consider whether this treatment is suitable for elderly people. These patients have high comorbidity and may require dialysis withdrawal in certain clinical circumstances. Advance directives (ADs) drawn up by patients facilitate treatment-related decisions if they lose cognitive capacity. Questionnaires dealing with possible extreme clinical circumstances can thus help clinicians and relatives reach pertinent decisions in such cases...
October 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#20
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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