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Renal Palliative Care

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163 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28212179/hard-choices-better-outcomes-a-review-of-shared-decision-making-and-patient-decision-aids-around-dialysis-initiation-and-conservative-kidney-management
#1
Janet L Davis, Sara N Davison
PURPOSE OF REVIEW: Patients reaching end-stage kidney disease face difficult decisions, including choosing among renal replacement therapies (RRTs). With an increasingly elderly and frail population, there is growing interest in conservative kidney management (CKM) as a viable alternative to dialysis. Shared decision-making (SDM) is a patient-centered approach to these decisions, in which choices are viewed within the explicitly discussed values and preferences of the patient. Patient decision aids (PDAs) are tools designed to facilitate these discussions...
February 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28184153/multimorbidity-as-specific-disease-combinations-an-important-predictor-factor-for-mortality-in-octogenarians-the-octabaix-study
#2
Assumpta Ferrer, Francesc Formiga, Héctor Sanz, Jesús Almeda, Glòria Padrós
BACKGROUND: The population is aging and multimorbidity is becoming a common problem in the elderly. OBJECTIVE: To explore the effect of multimorbidity patterns on mortality for all causes at 3- and 5-year follow-up periods. MATERIALS AND METHODS: A prospective community-based cohort (2009-2014) embedded within a randomized clinical trial was conducted in seven primary health care centers, including 328 subjects aged 85 years at baseline. Sociodemographic variables, sensory status, cardiovascular risk factors, comorbidity, and geriatric tests were analyzed...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28187786/low-renal-replacement-therapy-incidence-among-slowly-progressing-elderly-chronic-kidney-disease-patients-referred-to-nephrology-care-an-observational-study
#3
Ulrika Hahn Lundström, Alessandro Gasparini, Rino Bellocco, Abdul Rashid Qureshi, Juan-Jesus Carrero, Marie Evans
BACKGROUND: Elderly patients with advanced chronic kidney disease (CKD) have a high risk of death before reaching end-stage kidney disease. In order to allocate resources, such as advanced care nephrology where it is most needed, it is essential to know which patients have the highest absolute risk of advancing to renal replacement therapy (RRT). METHODS: We included all nephrology-referred CKD stage 3b-5 patients in Sweden 2005-2011 included in the Swedish renal registry (SRR-CKD) who had at least two serum creatinine measurements one year apart (+/- 6 months)...
February 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28152751/identifying-avoidable-terminal-oncology-icu-hospitalizations
#4
Andrew Hantel, Blase N Polite
: 56 Background: Eight percent of cancer patients expire in the ICU. There is no association between spending on aggressive end of life (EOL) care and survival outcomes. This aggressive care is also associated with reduced quality of life for patients and families. The National Quality Forum endorses the number of patients admitted to the ICU in the last 30 days of life as a quality of care measure. Our hypothesis is that a significant number of oncology patients suffer avoidable terminal ICU hospitalizations...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156631/survival-benefits-among-patients-with-end-stage-renal-disease-receiving-dialysis-versus-no-dialysis
#5
Maen Abdelrahim, Valda D Page, Shouhao Zhou, Chan Shen, Sriram Yennu, Bo Zhao, Joanna-Grace Mayo Manzano, Marina Ciny George, Joseph L Nates, Alvin Howard Moss, Rima Pai, Ala Abudayyeh
: 55 Background: Retrospective study of the outcomes of Stage IV Cancer Patients with End Stage Renal disease Receiving Dialysis and comparing the survival benefits among the patients who received Hemodialysis versus who didn't at a Comprehensive Cancer Center. METHODS: Retrospectively review all patients admitted to MDACC from 2005-2014 and diagnosed with stage IV solid tumor admitted with Acute kidney injury and a nephrology consult were included (N = 903) 19...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28094484/a-simplified-screening-tool-to-identify-seriously-ill-patients-in-the-emergency-department-for-referral-to-a-palliative-care-team
#6
Paolo Cotogni, Anna DE Luca, Andrea Evangelista, Claudia Filippini, Renata Gili, Antonio Scarmozzino, Giovannino Ciccone, Luca Brazzi
BACKGROUND: The aims of this study were to evaluate the feasibility of an Emergency Department (ED)-initiated screening to identify seriously ill patients in need of palliative care (PC) and to develop a simplified screening tool (SST). METHODS: Eligible patients with known diagnosis of chronic heart, lung, liver, and kidney failures, progressive neurological diseases or advanced cancer, awaiting to be hospitalized after an ED-visit, were assessed with the screening tool from the Italian Society Anaesthesia Analgesia Resuscitation Intensive Care (SIAARTI)...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28097174/uncertainty-the-overbearing-lived-experience-of-the-elderly-people-undergoing-hemodialysis-a-qualitative-study
#7
Robab Sahaf, Ehteram Sadat Ilali, Hamid Peyrovi, Ahmad Ali Akbari Kamrani, Fatemeh Spahbodi
BACKGROUND: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. METHODS: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis...
January 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28114529/extremis-a-documentary-look-at-end-of-life-decisions-in-the-icu
#8
Mara Buchbinder
No abstract text is available yet for this article.
17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28122500/costs-of-care-at-the-end-of-life-among-elderly-patients-with-chronic-kidney-disease-patterns-and-predictors-in-a-nationwide-cohort-study
#9
Bradley Chen, Victoria Y Fan, Yiing-Jenq Chou, Chin-Chi Kuo
BACKGROUND: Despite the urgent need for evidence to guide the end-of-life (EOL) care for patients with chronic kidney disease (CKD), we have limited knowledge of the costs and intensity of EOL care in this population. The present study examined patterns and predictors for EOL care intensity among elderly patients with CKD. METHODS: We conducted a retrospective nationwide cohort study utilizing the Taiwan National Health Insurance (NHI) Research Database. A total of 65,124 CKD patients aged ≥ 60 years, who died in hospitals or shortly after discharge between 2002 and 2012 were analyzed...
January 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28073820/predicting-6-month-mortality-risk-of-patients-commencing-dialysis-treatment-for-end-stage-kidney-disease
#10
Sara E Ivory, Kevan R Polkinghorne, Yeasmin Khandakar, Jessica Kasza, Sophia Zoungas, Retha Steenkamp, Paul Roderick, Rory Wolfe
BACKGROUND: There is evidence that end-stage kidney disease patients who are older or with more comorbidity may have a poor trade-off between benefits of dialysis and potential harms. We aimed to develop a tool for predicting patient mortality in the early stages of receiving dialysis. METHODS: In 23 658 patients aged 15+ years commencing dialysis between 2000 and 2009 in Australia and New Zealand a point score tool was developed to predict 6-month mortality based on a logistic regression analysis of factors available at dialysis initiation...
January 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28065454/the-prevalence-association-and-clinical-outcomes-of-frailty-in-maintenance-dialysis-patients
#11
So-Young Lee, Dong Ho Yang, Eunah Hwang, Seock Hui Kang, Sun-Hee Park, Tae Woo Kim, Duk Hyun Lee, Kisoo Park, Jun Chul Kim
OBJECTIVE: To investigate the clinical implications of frailty in chronic kidney disease patients undergoing maintenance hemodialysis and chronic peritoneal dialysis. DESIGN: In this prospective study, all of the participants completed the Short Form of the Kidney Disease Quality of Life questionnaire, Korean version, to determine their frailty phenotype. We also obtained blood chemistry and demographic data at enrollment. Data regarding the history of hospitalization and death were collected during the follow-up period...
March 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28065700/integrating-supportive-care-principles-into-dialysis-decision-making-a-primer-for-palliative-medicine-providers
#12
Alvin H Moss
Despite advances in predialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy, and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, preferences, and goals for treatment and address their patients' multifactorial suffering...
January 6, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28057703/advance-directives-and-end-of-life-care-among-nursing-home-residents-receiving-maintenance-dialysis
#13
Manjula Kurella Tamura, Maria E Montez-Rath, Yoshio N Hall, Ronit Katz, Ann M O'Hare
BACKGROUND AND OBJECTIVES: Little is known about the relation between the content of advance directives and downstream treatment decisions among patients receiving maintenance dialysis. In this study, we determined the prevalence of advance directives specifying treatment limitations and/or surrogate decision-makers in the last year of life and their association with end-of-life care among nursing home residents. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using national data from 2006 to 2007, we compared the content of advance directives among 30,716 nursing home residents receiving dialysis to 30,825 nursing home residents with other serious illnesses during the year before death...
January 5, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28057870/restricted-mean-survival-time-over-15-years-for-patients-starting-renal-replacement-therapy
#14
Cécile Couchoud, Emmanuelle Dantony, Mad-Hélénie Elsensohn, Emmanuel Villar, Cécile Vigneau, Olivier Moranne, Muriel Rabilloud, René Ecochard
BACKGROUND: The restricted mean survival time (RMST) estimates life expectancy up to a given time horizon and can thus express the impact of a disease. The aim of this study was to estimate the 15-year RMST of a hypothetical cohort of incident patients starting renal replacement therapy (RRT), according to their age, gender and diabetes status, and to compare it with the expected RMST of the general population. METHODS: Using data from 67 258 adult patients in the French Renal Epidemiology and Information Network (REIN) registry, we estimated the RMST of a hypothetical patient cohort (and its subgroups) for the first 15 years after starting RRT (cRMST) and used the general population mortality tables to estimate the expected RMST (pRMST)...
January 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28055045/the-effectiveness-and-value-of-palliative-care-in-the-outpatient-setting
#15
Courtney Cunningham, Daniel Ollendorf, Karin Travers
No abstract text is available yet for this article.
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28043082/a-dialysis-patient-s-choice-and-a-nephrologist-s-obligation-the-need-to-understand-and-value-the-patient-s-perspective
#16
EDITORIAL
Juliya Hemmett, Christopher W McIntyre
Patient-centered care is critical to the successful management of chronic diseases, such as chronic kidney disease. While a course of treatment may prolong life it may come with a reduced quality of life (QOL). For many patients, the decision to prolong life at the expense of lower QOL is not an obvious choice. Dialysis patients make treatment decisions daily, some of which can be life-altering. Therefore, the need for optimal decision-making may be more pressing in dialysis patients than in many other chronic disease states...
January 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/27994481/pharmacotherapeutic-considerations-for-chronic-pain-in-chronic-kidney-and-end-stage-renal-disease
#17
EDITORIAL
Roy O Mathew, Jeffrey J Bettinger, Erica L Wegrzyn, Jeffrey Fudin
No abstract text is available yet for this article.
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/28039288/how-long-do-patients-with-chronic-disease-expect-to-live-a-systematic-review-of-the-literature
#18
Barnaby Hole, Joseph Salem
OBJECTIVE: To systematically identify and summarise the literature on perceived life expectancy among individuals with non-cancer chronic disease. SETTING: Published and grey literature up to and including September 2016 where adults with non-cancer chronic disease were asked to estimate their own life expectancy. PARTICIPANTS: From 6837 screened titles, 9 articles were identified that met prespecified criteria for inclusion. Studies came from the UK, Netherlands and USA...
December 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/28031417/serious-illness-conversations-in-esrd
#19
Ernest I Mandel, Rachelle E Bernacki, Susan D Block
Dialysis-dependent ESRD is a serious illness with high disease burden, morbidity, and mortality. Mortality in the first year on dialysis for individuals over age 75 years old approaches 40%, and even those with better prognoses face multiple hospitalizations and declining functional status. In the last month of life, patients on dialysis over age 65 years old experience higher rates of hospitalization, intensive care unit admission, procedures, and death in hospital than patients with cancer or heart failure, while using hospice services less...
December 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27932044/families-perception-of-end-of-life-care-for-patients-with-serious-illness
#20
EDITORIAL
Susan P Y Wong, Ann M O'Hare
No abstract text is available yet for this article.
December 5, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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