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Renal Palliative Care

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200 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28901990/the-impact-of-frailty-on-outcomes-in-dialysis
#1
John Sy, Kirsten L Johansen
: Advances in the assessment of frailty among dialysis patients have improved our understanding of the association between frailty and poor outcomes. We review recent studies that assess the association between frailty and mortality, falls and fractures, hospitalizations, cognitive impairment, and other less traditional outcomes. A greater understanding of these associations may provide more accurate prognostic information, allow tailored interventions, and improve discussions between patients and providers about the risks and benefits of the dialysis procedure...
September 9, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28848106/making-sense-of-prognostic-information-about-maintenance-dialysis-versus-conservative-care-for-treatment-of-advanced-kidney-disease
#2
Susan P Y Wong, Ann M O'Hare
No abstract text is available yet for this article.
August 26, 2017: Nephron
https://www.readbyqxmd.com/read/28842059/steps-toward-sustainable-change-in-advance-care-planning
#3
EDITORIAL
Jane O Schell, Daniel Lam
No abstract text is available yet for this article.
September 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28742145/survival-analysis-of-conservative-vs-dialysis-treatment-of-elderly-patients-with-ckd-stage-5
#4
Roman Reindl-Schwaighofer, Alexander Kainz, Michael Kammer, Alexandra Dumfarth, Rainer Oberbauer
Elderly patients represent a growing population among people suffering from ESRD. So far only limited data on actual survival benefits of elderly adults initiating dialysis have been published. Besides the high burden of preexisting comorbidities, dialysis treatment itself may be associated with a further deterioration in functional status in this population. We retrospectively analyzed the Austrian Dialysis and Transplant Registry and identified 8,622 patients who started maintenance hemodialysis after the age of 65 years between 2002 and 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28683758/decisions-regarding-admission-to-the-icu-and-international-initiatives-to-improve-the-decision-making-process
#5
EDITORIAL
Christopher Bassford
No abstract text is available yet for this article.
July 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28672336/responding-to-intractable-terminal-suffering-the-role-of-terminal-sedation-and-voluntary-refusal-of-food-and-fluids
#6
Timothy E Quill, Ira R Byock
When provided by a skilled, multidisciplinary team, palliative care is highly effective at addressing the physical, psychological, social, and spiritual needs of dying patients and their families. However, some patients who have witnessed harsh death want reassurance that they can escape if their suffering becomes intolerable. In addition, a small percentage of terminally ill patients receiving comprehensive care reach a point at which their suffering becomes severe and unacceptable despite unrestrained palliative efforts; some of these patients request that death be hastened...
March 7, 2000: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28655708/characteristics-and-outcomes-of-in-hospital-palliative-care-consultation-among-patients-with-renal-disease-versus-other-serious-illnesses
#7
Vanessa Grubbs, David O'Riordan, Steve Pantilat
BACKGROUND AND OBJECTIVES: Despite significant morbidity and mortality associated with ESRD, these patients receive palliative care services much less often than patients with other serious illnesses, perhaps because they are perceived as having less need for such services. We compared characteristics and outcomes of hospitalized patients in the United States who had a palliative care consultation for renal disease versus other serious illnesses. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this observational study, we used data collected by the Palliative Care Quality Network, a national palliative care quality improvement collaborative...
July 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28638606/palliative-care-for-patients-with-end-stage-renal-disease-approach-to-treatment-that-aims-to-improve-quality-of-life-and-relieve-suffering-for-patients-and-families-with-chronic-illnesses
#8
Amy Rak, Rupesh Raina, Theodore T Suh, Vinod Krishnappa, Jessica Darusz, Charles W Sidoti, Mona Gupta
Providing end-of-life care to patients suffering from chronic kidney disease (CKD) and/or end-stage renal disease often presents ethical challenges to families and health care providers. However, as the conditions these patients present with are multifaceted in nature, so should be the approach when determining prognosis and treatment strategies for this patient population. Having an interdisciplinary palliative team in place to address any concerns that may arise during conversations related to end-of-life care encourages effective communication between the patient, the family and the medical team...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#9
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28635159/nutrition-in-renal-supportive-care-patient-driven-and-flexible
#10
REVIEW
Jessica Stevenson, Anthony Meade, Ann-Maree Randall, Karen Manley, Stephanie Notaras, Susan Heaney, Maria Chan, Alison Smyth, Elizabeth Josland, Frank Brennan, Mark A Brown
Renal Supportive Care is an alternative treatment pathway in advanced Chronic Kidney Disease (CKD) that is being increasingly adopted, particularly in the elderly. RSC utilises principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non-dialysis pathway. Nutrition management is often an under-recognised component of care, and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of RSC are met...
June 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28596151/survey-on-advance-care-planning-of-italian-outpatients-on-chronic-haemodialysis
#11
Nicola Panocchia, Giuseppe Tonnara, Roberta Minacori, Dario Sacchini, Maurizio Bossola, Luigi Tazza, Giovanni Gambaro, Antonio Gioacchino Spagnolo
OBJECTIVES: The clinical practice guidelines published by the Renal Physicians Association (USA) recommend instituting advance care planning (ACP) for patients with end-stage renal disease. Studies on this issue are lacking in Italy. Our aim was to determine the attitudes of patients on ACP in our dialysis centre. METHODS: We performed a cross-sectional survey. We recruited patients on maintenance haemodialysis (HD) at Hemodialysis Center of Università Cattolica del Sacro Cuore, from 1 March 2014 to 31 March 2015...
June 8, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28558109/modern-death-how-medicine-changed-the-end-of-life-a-book-review
#12
Joshua R Lakin
No abstract text is available yet for this article.
May 30, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28538218/dialysis-therapy-and-conservative-management-of-advanced-chronic-kidney-disease-in-the-elderly-a-systematic-review
#13
Supakanya Wongrakpanich, Paweena Susantitaphong, Suramath Isaranuwatchai, Jirat Chenbhanich, Somchai Eiam-Ong, Bertrand L Jaber
BACKGROUND: Dialysis in older adults with chronic kidney disease (CKD) and comorbidities may not be associated with improved life expectancy compared to conservative management. To inform clinical practice, we performed a systematic review of all available studies examining this hypothesis. METHODS: We performed a systematic review of retrospective and prospective cohort studies of older adults with stage-5 CKD who chose dialysis (hemodialysis or peritoneal dialysis) or opted for conservative management (including management of complications of CKD and palliative care)...
May 25, 2017: Nephron
https://www.readbyqxmd.com/read/28535240/finding-joy-in-practice-cocreation-in-palliative-care
#14
Kathryn B Kirkland
No abstract text is available yet for this article.
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28526493/improving-comfort-around-dying-in-elderly-people-a-cluster-randomised-controlled-trial
#15
Kim Beernaert, Tinne Smets, Joachim Cohen, Rebecca Verhofstede, Massimo Costantini, Kim Eecloo, Nele Van Den Noortgate, Luc Deliens
BACKGROUND: Over 50% of elderly people die in acute hospital settings, where the quality of end-of-life care is often suboptimum. We aimed to assess the effectiveness of the Care Programme for the Last Days of Life (CAREFuL) at improving comfort and quality of care in the dying phase in elderly people. METHODS: We did a cluster randomised controlled trial in acute geriatric wards in ten hospitals in Flemish Region, Belgium, between Oct 1, 2012, and March 31, 2015...
July 8, 2017: Lancet
https://www.readbyqxmd.com/read/28520863/persistent-gaps-in-use-of-advance-directives-among-nursing-home-residents-receiving-maintenance-dialysis
#16
Manjula Kurella Tamura, Sai Liu, Maria E Montez-Rath, Ann M O'Hare, Yoshio N Hall, Karl A Lorenz
No abstract text is available yet for this article.
August 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28506243/cost-analysis-of-the-very-elderly-admitted-to-intensive-care-units
#17
Nicolas Chin-Yee, Gianni D'Egidio, Kednapa Thavorn, Daren Heyland, Kwadwo Kyeremanteng
BACKGROUND: Very elderly patients are often admitted to intensive care units (ICUs) despite poor outcomes and frequent preference to avoid unnecessary prolongation of life. We sought to determine the cost of ICU admission for the very elderly and the factors influencing this cost. METHODS: This prospective, observational cohort study included patients ≥80 years old admitted to 22 Canadian ICUs from 2009 to 2013. A subset of consenting individuals comprised a longitudinal cohort followed over 12 months...
May 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28478971/beyond-resources-denying-parental-requests-for-futile-treatment
#18
Dominic Wilkinson
No abstract text is available yet for this article.
May 13, 2017: Lancet
https://www.readbyqxmd.com/read/28464924/frailty-in-end-stage-renal-disease-comparing-patient-caregiver-and-clinician-perspectives
#19
David A Clark, Usman Khan, Bryce A Kiberd, Colin C Turner, Alison Dixon, David Landry, Heather C Moffatt, Paige A Moorhouse, Karthik K Tennankore
BACKGROUND: Frailty is associated with poor outcomes for patients on dialysis and is traditionally measured using tools that assess physical impairment. Alternate measurement tools highlight cognitive and functional domains, requiring clinician, patient, and/or caregiver input. In this study, we compared frailty measures for incident dialysis patients that incorporate patient, clinician, and caregiver perspectives with an aim to contrast the measured prevalence of frailty using tools derived from different conceptual frameworks...
May 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28417662/clinician-views-of-patient-decisional-conflict-when-deciding-between-dialysis-and-conservative-management-qualitative-findings-from-the-palliative-care-in-chronic-kidney-disease-packs-study
#20
Helen Noble, Kevin Brazil, Aine Burns, Sarah Hallahan, Charles Normand, Paul Roderick, Colin Thompson, Peter Maxwell, Magdi Yaqoob
BACKGROUND: Only a paucity of studies have addressed clinician perspectives on patient decisional conflict, in making complex decisions between dialysis and conservative management (renal supportive and palliative care). AIM: To explore clinician views on decisional conflict in patients with end-stage kidney disease. DESIGN: Interpretive, qualitative study. SETTING AND PARTICIPANTS: As part of the wider National Institute for Health Research, PAlliative Care in chronic Kidney diSease study, semi-structured interviews were conducted with clinicians (nephrologists n = 12; 7 female and clinical nurse specialists n = 15; 15 female) across 10 renal centres in the United Kingdom...
April 1, 2017: Palliative Medicine
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