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Renal Palliative Care

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212 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29130949/performance-of-the-surprise-question-compared-to-prediction-models-in-hemodialysis-patients-a-prospective-study
#1
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)...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29132161/a-research-agenda-for-high-value-palliative-care
#2
Katherine R Courtright, J Brian Cassel, Scott D Halpern
No abstract text is available yet for this article.
November 14, 2017: 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28901990/the-impact-of-frailty-on-outcomes-in-dialysis
#13
John Sy, Kirsten L Johansen
PURPOSE OF REVIEW: Frailty is highly prevalent in the dialysis population and is associated with mortality. Recent studies have suggested that other dialysis outcomes are compromised in frail individuals. While we do not yet have a consensus as to the best measure of frailty, identification of these poor outcomes and their magnitude of association with frailty will help improve prognostication, allow for earlier interventions, and improve provider-to-patient communication. RECENT FINDINGS: The most widely used assessment of frailty is Fried's physical performance criteria...
November 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
#14
Susan P Y Wong, Ann M O'Hare
No abstract text is available yet for this article.
2017: Nephron
https://www.readbyqxmd.com/read/28842059/steps-toward-sustainable-change-in-advance-care-planning
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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