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Renal Palliative Care

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143 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/27910190/the-transplant-palliative-care-clinic-an-early-palliative-care-model-for-patients-in-a-transplant-program
#1
Kirsten Wentlandt, Angela Dall'Osto, Nicole Freeman, Lisa W Le, Ebru Kaya, Heather Ross, Lianne G Singer, Susan Abbey, Hance Clarke, Camilla Zimmermann
Although patients within a transplant program are awaiting or have received disease modifying or curative treatment, they are also facing advanced illness and the possibility of death. The involvement of specialized palliative care services for these patients may improve symptom management and facilitate advance care planning. However, patients in organ transplantation programs have difficulty accessing palliative care resources and often do so only sporadically in the inpatient setting. Currently, there is little access to ambulatory palliative care for these patients and there have been no descriptions of programs delivering such care in the medical literature...
December 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27902586/neurological-psychological-and-cognitive-disorders-in-patients-with-chronic-kidney-disease-on-conservative-and-replacement-therapy
#2
Silvia Lai, Oriano Mecarelli, Patrizia Pulitano, Roberto Romanello, Leonardo Davi, Alessia Zarabla, Amalia Mariotti, Maria Carta, Giorgia Tasso, Luca Poli, Anna Paola Mitterhofer, Massimo Testorio, Nicla Frassetti, Paola Aceto, Alessandro Galani, Carlo Lai
Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy.Seventy-four clinically stable patients affected by CKD on conservative therapy, replacement therapy (hemodialysis (HD), peritoneal dialysis (PD)), or with kidney transplantation (KT) and 25 healthy controls (HC), matched for age and sex were enrolled...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893131/association-between-palliative-care-and-patient-and-caregiver-outcomes-a-systematic-review-and-meta-analysis
#3
Dio Kavalieratos, Jennifer Corbelli, Di Zhang, J Nicholas Dionne-Odom, Natalie C Ernecoff, Janel Hanmer, Zachariah P Hoydich, Dara Z Ikejiani, Michele Klein-Fedyshin, Camilla Zimmermann, Sally C Morton, Robert M Arnold, Lucas Heller, Yael Schenker
Importance: The use of palliative care programs and the number of trials assessing their effectiveness have increased. Objective: To determine the association of palliative care with quality of life (QOL), symptom burden, survival, and other outcomes for people with life-limiting illness and for their caregivers. Data Sources: MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL to July 2016. Study Selection: Randomized clinical trials of palliative care interventions in adults with life-limiting illness...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27881247/pain-management-in-ckd-a-guide-for-nephrology-providers
#4
Holly M Koncicki, Mark Unruh, Jane O Schell
Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis...
November 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#5
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27856091/a-clinical-risk-prediction-tool-for-6-month-mortality-after-dialysis-initiation-among-older-adults
#6
James P Wick, Tanvir C Turin, Peter D Faris, Jennifer M MacRae, Robert G Weaver, Marcello Tonelli, Braden J Manns, Brenda R Hemmelgarn
BACKGROUND: Information on an individual's risk for death following dialysis therapy initiation may inform the decision to initiate maintenance dialysis for older adults. We derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment. STUDY DESIGN: Prediction model using retrospective administrative and clinical data. SETTING & PARTICIPANTS: We linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada, who initiated maintenance dialysis therapy (excluding acute kidney injury) in May 2003 to March 2012...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27856490/prevalence-and-contents-of-advance-directives-of-patients-with-esrd-receiving-dialysis
#7
Molly A Feely, Daniel Hildebrandt, Jithinraj Edakkanambeth Varayil, Paul S Mueller
BACKGROUND AND OBJECTIVES: ESRD requiring dialysis is associated with increased morbidity and mortality rates, including increased rates of cognitive impairment, compared with the general population. About one quarter of patients receiving dialysis choose to discontinue dialysis at the end of life. Advance directives are intended to give providers and surrogates instruction on managing medical decision making, including end of life situations. The prevalence of advance directives is low among patients receiving dialysis...
November 17, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27863475/spanish-modified-version-of-the-palliative-care-outcome-scale-symptoms-renal-cross-cultural-adaptation-and-validation
#8
Daniel Gutiérrez-Sánchez, Juan P Leiva-Santos, Rosa Sánchez-Hernández, Domingo Hernández-Marrero, Antonio I Cuesta-Vargas
BACKGROUND: Patients with chronic kidney disease (CKD) have a high symptoms burden that is related to a poor health-related quality of life (HRQoL) and high costs of care. Validated instruments may be useful for assessing the symptoms and monitoring outcomes in these patients. The Palliative care Outcome Scale-Symptoms Renal (POS-S Renal) is a patient-reported outcome measure for assessing symptoms in CKD stage 4-5. This study is the first cross-cultural adaptation and psychometric analysis of this clinical tool...
November 18, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27802496/low-completion-and-disparities-in-advance-care-planning-activities-among-older-medicare-beneficiaries
#9
Krista L Harrison, Emily R Adrion, Christine S Ritchie, Rebecca L Sudore, Alexander K Smith
No abstract text is available yet for this article.
December 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27747860/understanding-the-continuation-of-potentially-inappropriate-medications-at-the-end-of-life-perspectives-from-individuals-and-their-relatives-and-physicians
#10
Eric C T Geijteman, Marianne K Dees, Marlies M A Tempelman, Bregje A A Huisman, Jimmy J Arevalo, Roberto S G M Perez, Lia van Zuylen, Agnes van der Heide
No abstract text is available yet for this article.
October 17, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#11
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
https://www.readbyqxmd.com/read/27668403/going-home-dying
#12
Mitsuru Mukaigawara
No abstract text is available yet for this article.
September 26, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27693262/trends-in-receipt-of-intensive-procedures-at-the-end-of-life-among-patients-treated-with-maintenance-dialysis
#13
Nwamaka D Eneanya, Susan M Hailpern, Ann M O'Hare, Manjula Kurella Tamura, Ronit Katz, William Kreuter, Maria E Montez-Rath, Paul L Hebert, Yoshio N Hall
BACKGROUND: Many dialysis patients receive intensive procedures intended to prolong life at the very end of life. However, little is known about trends over time in the use of these procedures. We describe temporal trends in receipt of inpatient intensive procedures during the last 6 months of life among patients treated with maintenance dialysis. STUDY DESIGN: Mortality follow-back study. SETTING & PARTICIPANTS: 649,607 adult Medicare beneficiaries on maintenance dialysis therapy who died in 2000 to 2012...
September 29, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27697783/conservative-management-and-end-of-life-care-in-an-australian-cohort-with-esrd
#14
Rachael L Morton, Angela C Webster, Kevin McGeechan, Kirsten Howard, Fliss E M Murtagh, Nicholas A Gray, Peter G Kerr, Michael J Germain, Paul Snelling
BACKGROUND AND OBJECTIVES: We aimed to determine the proportion of patients who switched to dialysis after confirmed plans for conservative care and compare survival and end of life care among patients choosing conservative care with those initiating RRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A cohort study of 721 patients on incident dialysis, patients receiving transplants, and conservatively managed patients from 66 Australian renal units entered into the Patient Information about Options for Treatment Study from July 1 to September 30, 2009 were followed for 3 years...
October 3, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27660307/practice-change-is-needed-for-dialysis-decision-making-with-older-adults-with-advanced-kidney-disease
#15
EDITORIAL
Jennifer S Scherer, Alvin H Moss
No abstract text is available yet for this article.
September 22, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27521115/limited-health-literacy-in-advanced-kidney-disease
#16
Dominic M Taylor, John A Bradley, Clare Bradley, Heather Draper, Rachel Johnson, Wendy Metcalfe, Gabriel Oniscu, Matthew Robb, Charles Tomson, Chris Watson, Rommel Ravanan, Paul Roderick
Limited health literacy may reduce the ability of patients with advanced kidney disease to understand their disease and treatment and take part in shared decision making. In dialysis and transplant patients, limited health literacy has been associated with low socioeconomic status, comorbidity, and mortality. Here, we investigated the prevalence and associations of limited health literacy using data from the United Kingdom-wide Access to Transplantation and Transplant Outcome Measures (ATTOM) program. Incident dialysis, incident transplant, and transplant wait-listed patients ages 18 to 75 were recruited from 2011 to 2013 and data were collected from patient questionnaires and case notes...
September 2016: Kidney International
https://www.readbyqxmd.com/read/27510452/supportive-care-time-to-change-our-prognostic-tools-and-their-use-in-ckd
#17
Cécile Couchoud, Brenda Hemmelgarn, Peter Kotanko, Michael J Germain, Olivier Moranne, Sara N Davison
In using a patient-centered approach, neither a clinician nor a prognostic score can predict with absolute certainty how well a patient will do or how long he will live; however, validated prognostic scores may improve accuracy of prognostic estimates, thereby enhancing the ability of the clinicians to appreciate the individual burden of disease and the prognosis of their patients and inform them accordingly. They may also facilitate nephrologist's recommendation of dialysis services to those who may benefit and proposal of alternative care pathways that might better respect patients' values and goals to those who are unlikely to benefit...
August 10, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27510453/supportive-care-comprehensive-conservative-care-in-end-stage-kidney-disease
#18
Fliss E M Murtagh, Aine Burns, Olivier Moranne, Rachael L Morton, Saraladevi Naicker
Comprehensive conservative (nondialytic) kidney care is widely recognized and delivered but until recently, has not been clearly defined. We provide a clear definition of comprehensive conservative care. This includes interventions to delay progression of kidney disease and minimize complications as well as detailed communication, shared decision making, advance care planning, and psychologic and family support. It does not include dialysis. Limited epidemiologic evidence from Australia and Canada indicates that, for every new person diagnosed with ESRD who receives dialysis or transplant, there is one new person who is managed conservatively (either actively or not)...
August 10, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27510454/supportive-care-integration-of-patient-centered-kidney-care-to-manage-symptoms-and-geriatric-syndromes
#19
Sara N Davison, Sarbjit Vanita Jassal
Dialysis care is often associated with poor outcomes including low quality of life (QOL). To improve patient-reported outcomes, incorporation of the patient's needs and perspective into the medical care they receive is essential. This article provides a framework to help clinicians integrate symptom assessment and other measures such as QOL and frailty scores into a clinical approach to the contemporary supportive care of patients with advanced CKD. This approach involves (1) defining our understanding of kidney supportive care, patient-centered dialysis, and palliative dialysis; (2) understanding and recognizing common symptoms associated with advanced CKD; (3) discussing the concepts of physical function, frailty, and QOL and their role in CKD; and (4) identifying the structural and process barriers that may arise when patient-centered dialysis is being introduced into clinical practice...
August 10, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27510455/supportive-care-economic-considerations-in-advanced-kidney-disease
#20
Rachael L Morton, Manjula Kurella Tamura, Joanna Coast, Sara N Davison
Kidney supportive care describes multiple interventions for patients with advanced CKD that focus on improving the quality of life and addressing what matters most to patients. This includes shared decision making and aligning treatment plans with patient goals through advance care planning and providing relief from pain and other distressing symptoms. Kidney supportive care is an essential component of quality care throughout the illness trajectory. However, in the context of limited health care resources, evidence of its cost-effectiveness is required to support decisions regarding appropriate resource allocation...
August 10, 2016: Clinical Journal of the American Society of Nephrology: CJASN
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