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Collections Advance Care Planning, Renal S...

Advance Care Planning, Renal Supportive Care, Bioethics, Conservative Kidney Management, Dialysis Withdrawal, and Palliative Care

https://read.qxmd.com/read/38446384/kidney-supportive-care-for-advanced-chronic-and-end-stage-kidney-disease-a-retrospective-cohort-study
#1
JOURNAL ARTICLE
Angela Recchia, Roberta Casazza, Mario Cozzolino, Barbara Rizzi, Maria Cristina Pinerolo de Septis
BACKGROUND: Kidney supportive care is an interdisciplinary model of person-centred medicine, suitable for patients with advanced Chronic Kidney Disease (CKD) and with End-Stage Kidney Disease (ESKD). There is little information on routine care, and palliative care remains poorly integrated into standard nephrology care. The aim of this study was to describe our experience in integrating a palliative care approach into the nephrology care of advanced chronic and end-stage kidney disease...
March 6, 2024: Journal of Nephrology
https://read.qxmd.com/read/38407155/intention-to-sign-an-advance-directive-among-nephrology-medical-staff-and-its-related-factors
#2
JOURNAL ARTICLE
Li Fang, Li-Ping Hsiao, Shu-Hui Fang
BACKGROUND: Advance care planning enables people to record their future health and care wishes and appoint someone as an advocate. An advance directive can be made in the event that a person is incapacitated, so that their wishes are still upheld. The beliefs of the nephrology team might affect patients' choices and willingness to sign an advance directive. To increase the number of dialysis patients who have signed an advance directive, it is necessary to educate the nephrology medical staff...
February 2, 2024: International Journal of Palliative Nursing
https://read.qxmd.com/read/38402499/perspectives-on-the-optimal-timing-of-advance-care-planning-among-japanese-patients-undergoing-dialysis-and-clinicians-a-cross-sectional-study
#3
JOURNAL ARTICLE
Yasushi Tsujimoto, Takuya Aoki, Sayaka Shimizu, Hiroo Kawarazaki, Kaori Kohatsu, Takeshi Nakata, Ann M O'Hare, Yugo Shibagaki, Yosuke Yamamoto, Jun Miyashita
KEY MESSAGES: The majority of dialysis patients and clinicians favor early advance care planning in our sample. Yet, there is a disconnect: only 11% of patients discussed future care with their clinicians. Our findings indicate Japanese dialysis patients and clinicians support proactive advance care planning at or before dialysis initiation. BACKGROUND: Little is known about the optimal timing of discussions about advance care planning among dialysis patients and clinicians engaged in dialysis care...
February 25, 2024: Clinical and Experimental Nephrology
https://read.qxmd.com/read/38236475/advance-care-planning-for-patients-with-end-stage-kidney-disease-on-dialysis-narrative-review-of-the-current-evidence-and-future-considerations
#4
REVIEW
S F Adenwalla, P O'Halloran, C Faull, F E M Murtagh, M P M Graham-Brown
Patients with end-stage kidney disease (ESKD) have a high symptom-burden and high rates of morbidity and mortality. Despite this, evidence has shown that this patient group does not have timely discussions to plan for deterioration and death, and at the end of life there are unmet palliative care needs. Advance care planning is a process that can help patients share their personal values and preferences for their future care and prepare for declining health. Earlier, more integrated and holistic advance care planning has the potential to improve access to care services, communication, and preparedness for future decision-making and changing circumstances...
January 18, 2024: Journal of Nephrology
https://read.qxmd.com/read/38227032/default-palliative-care-consultation-for-seriously-ill-hospitalized-patients-a-pragmatic-cluster-randomized-trial
#5
RANDOMIZED CONTROLLED TRIAL
Katherine R Courtright, Vanessa Madden, Brian Bayes, Marzana Chowdhury, Casey Whitman, Dylan S Small, Michael O Harhay, Suzanne Parra, Elizabeth Cooney-Zingman, Mary Ersek, Gabriel J Escobar, Sarah H Hill, Scott D Halpern
IMPORTANCE: Increasing inpatient palliative care delivery is prioritized, but large-scale, experimental evidence of its effectiveness is lacking. OBJECTIVE: To determine whether ordering palliative care consultation by default for seriously ill hospitalized patients without requiring greater palliative care staffing increased consultations and improved outcomes. DESIGN, SETTING, AND PARTICIPANTS: A pragmatic, stepped-wedge, cluster randomized trial was conducted among patients 65 years or older with advanced chronic obstructive pulmonary disease, dementia, or kidney failure admitted from March 21, 2016, through November 14, 2018, to 11 US hospitals...
January 16, 2024: JAMA
https://read.qxmd.com/read/38186878/factors-that-influence-the-selection-of-conservative-management-for-end-stage-renal-disease-a-systematic-review
#6
JOURNAL ARTICLE
Pavithra Sakthivel, Alyaa Mostafa, Olalekan Lee Aiyegbusi
BACKGROUND: Most patients with end-stage renal disease (ESRD) are managed with dialysis and less commonly kidney transplantation. However, not all are suitable for or desire either of these renal replacement therapies. Conservative management (CM) is an option. However, the selection of CM is often not easy for patients and clinicians. The aim of this systematic review is to identify the key factors that influence the selection of CM for ESRD. METHODS: Medline, Embase, PsychINFO, and CINAHL Plus were systematically searched from inception to 10 September 2021...
January 2024: Clinical Kidney Journal
https://read.qxmd.com/read/38182300/conservative-kidney-management-and-kidney-supportive-care-core-components-of-integrated-care-for-people-with-kidney-failure
#7
REVIEW
Sara N Davison, Wolfgang Pommer, Mark A Brown, Claire A Douglas, Samantha L Gelfand, Irmingarda P Gueco, Barnaby D Hole, Sumiko Homma, Rümeyza T Kazancıoğlu, Harumi Kitamura, Sahar H Koubar, Rene Krause, Kelly C Li, Aoife C Lowney, Shankar P Nagaraju, Abdou Niang, Gregorio T Obrador, Yoichi Ohtake, Jane O Schell, Jennifer S Scherer, Brendan Smyth, Kaichiro Tamba, Nandini Vallath, Nicola Wearne, Elena Zakharova, Carlos Zúñiga, Frank P Brennan
Integrated kidney care requires synergistic linkage between preventative care for people at risk for chronic kidney disease and health services providing care for people with kidney disease, ensuring holistic and coordinated care as people transition between acute and chronic kidney disease and the 3 modalities of kidney failure management: conservative kidney management, transplantation, and dialysis. People with kidney failure have many supportive care needs throughout their illness, regardless of treatment modality...
January 2024: Kidney International
https://read.qxmd.com/read/38118003/navigating-and-communicating-about-serious-illness-and-end-of-life
#8
REVIEW
Vicki A Jackson, Linda Emanuel
New England Journal of Medicine, Volume 390, Issue 1, Page 63-69, January 2024.
December 20, 2023: New England Journal of Medicine
https://read.qxmd.com/read/38116998/identifying-experiences-of-supportive-care-of-children-and-young-people-affected-by-kidney-failure-a-qualitative-systematic-review
#9
REVIEW
C Paterson, M Turner, M-E Hooper, E Ladbrook, L Macauley, A McKie
BACKGROUND: Children and young people affected by kidney failure experience complexities in their care. Little is known about the unique needs of this young patient population group living with a long-term condition. OBJECTIVE: A meta-aggregation of all qualitative studies was conducted to identify experiences of supportive care among children and young people living with kidney failure. METHODS: A systematic review of qualitative studies was conducted following the Joanna Briggs Institute meta-aggregation method...
December 20, 2023: Journal of Renal Care
https://read.qxmd.com/read/38106567/urgency-for-kidney-palliative-care-in-chinese-maintenance-hemodialysis-patients
#10
JOURNAL ARTICLE
Shuo Zhang, Wenbo Zhu, Jinghua Xia, Ying Zheng, Xuemei Li, Limeng Chen, Xiaohong Ning, Yan Qin
INTRODUCTION: The aim of this study is to understand nephrology medical staff's awareness of, basic knowledge of, practical ability of, and the barriers to palliative kidney care to patients on maintenance hemodialysis (HD) in mainland China. METHODS: This cross-sectional descriptive study employed convenience sampling of medical staff (physicians and nurses) working in nephrology departments in mainland China. Independent predictors of self-assessment ability for palliative care (PC) were determined using multivariate binary logistic regression...
December 2023: KI Reports
https://read.qxmd.com/read/37928753/conservative-kidney-management-practice-patterns-and-resources-in-the-united-states-a-cross-sectional-analysis-of-ckdopps-chronic-kidney-disease-outcomes-and-practice-patterns-study-data
#11
JOURNAL ARTICLE
Jennifer S Scherer, Brian Bieber, Natalia Alencar de Pinho, Tahsin Masud, Bruce Robinson, Roberto Pecoits-Filho, Joy Schiedell, Keith Goldfeld, Joshua Chodosh, David M Charytan
RATIONALE & OBJECTIVE: Conservative kidney management (CKM) is a viable treatment option for many patients with chronic kidney disease. However, CKM practices and resources in the United States are not well described. We undertook this study to gain a better understanding of factors influencing uptake of CKM by describing: (1) characteristics of patients who choose CKM, (2) provider practice patterns relevant to CKM, and (3) CKM resources available to providers. STUDY DESIGN: Cross-sectional study...
November 2023: Kidney medicine
https://read.qxmd.com/read/37891520/factors-associated-with-quality-of-life-in-patients-with-kidney-failure-managed-conservatively-and-with-dialysis-a-cross-sectional-study
#12
JOURNAL ARTICLE
Sarah So, Mark A Brown, Kelly Li
BACKGROUND: Later stage chronic kidney disease (CKD) is associated with poorer self-perceived health-related quality of life (HRQOL), a major consideration for many patients. Psychological factors such as depression and anxiety have been linked with poorer HRQOL. We aimed to determine if anxiety or depressive symptoms are significantly associated with self-perceived health-related quality of life, in patients with CKD Stage 5. The secondary aim was to determine which patient-associated factors are associated with HRQOL in patients with CKD Stage 5...
October 27, 2023: BMC Nephrology
https://read.qxmd.com/read/37884858/perceptions-and-attitudes-of-kidney-supportive-care-among-elderly-patients-with-advanced-chronic-kidney-disease-and-dialysis-healthcare-professionals-in-china-a-qualitative-study
#13
JOURNAL ARTICLE
Xue Li, Jin Kai Luo
PURPOSE: Kidney supportive care (KSC) represents a novel approach wherein a multidisciplinary team of nephrology experts offers active symptom management, advance care planning, shared decision-making, conservative treatment, and end-of-life care. This study is aimed at providing comprehensive insights and evaluations regarding the understanding and perspectives of Chinese healthcare professionals, including nephrologists and dialysis nurses, as well as elderly individuals aged 60 and above who are afflicted with chronic kidney disease...
October 26, 2023: BMC Nephrology
https://read.qxmd.com/read/37742209/shared-decision-making-in-patients-with-kidney-failure
#14
JOURNAL ARTICLE
Mehmet Kanbay, Carlo Basile, Yuri Battaglia, Alessandro Mantovani, Furkan Yavuz, Francesco Pizzarelli, Valerie A Luyckx, Adrian Covic, Vassilios Liakopoulos, Sandip Mitra
'Elderly' is most commonly defined as an individual aged 65 years or older. However, this definition fails to account for the differences in genetics, lifestyle and overall health that contribute to significant heterogeneity among the elderly beyond chronological age. As the world population continues to age, the prevalence of chronic diseases, including chronic kidney disease (CKD), is increasing and CKD frequently progresses to kidney failure. Moreover, frailty represents a multidimensional clinical entity highly prevalent in this population, which needs to be adequately assessed to inform and support medical decisions...
September 23, 2023: Nephrology, Dialysis, Transplantation
https://read.qxmd.com/read/37669893/choosing-conservative-care-in-advanced-chronic-kidney-disease-patients-perspectives
#15
JOURNAL ARTICLE
Micha Jongejan, Sanne de Lange, Willem Jan W Bos, Arwen H Pieterse, Wanda S Konijn, Marjolijn van Buren, Alferso C Abrahams, Mathijs van Oevelen
BACKGROUND: Conservative care (CC) is a viable treatment option for some patients with kidney failure. Choosing between dialysis and CC can be a complex decision, in which involvement of patients is desirable. Gaining insight into the experiences and preferences of patients regarding this decision-making process is an important initial step to improve care. We aimed to identify what is known about the perspective of patients regarding decision-making when considering CC. METHODS: PubMed, EMBASE and Cochrane databases were systematically searched on 23 February 2023 for qualitative and quantitative studies on patient-reported experiences on decision-making about CC...
September 5, 2023: Nephrology, Dialysis, Transplantation
https://read.qxmd.com/read/37723595/recommendations-on-palliative-care-aspects-in-intensive-care-medicine
#16
REVIEW
Guido Michels, Manuela Schallenburger, Martin Neukirchen
BACKGROUND: The timely integration of palliative care is important for patients suffering from various advanced diseases with limited prognosis. While a German S-3-guideline on palliative care exists for patients with incurable cancer, a recommendation for non-oncological patients and especially for integration of palliative care into intensive care medicine is missing to date. METHOD: Ten German medical societies worked on recommendations on palliative care aspects in intensive care in a consensus process from 2018 to 2023...
September 18, 2023: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/37573769/teaching-conservative-kidney-management-and-other-palliative-care-skills-in-nephrology-fellowships
#17
REVIEW
Amanda K Leonberg-Yoo, Scott J Gilbert
Offering and providing effective conservative kidney management (CKM) for patients with end-stage kidney disease who do not want dialysis is a foundational skill that all nephrology fellows should learn during fellowship training. However, the current educational landscape in fellowship training programs is sparse and is not recognized currently as a skill within the Accreditation Council for Graduate Medical Education (ACGME) guidelines. Moreover, there is no standardized curriculum, methods of assessment of this learning objective, and no structure for implementation within general and subspecialty nephrology training programs...
January 2023: Seminars in Nephrology
https://read.qxmd.com/read/37579517/dialysis-access-considerations-in-kidney-palliative-care
#18
REVIEW
Samantha L Gelfand, Dirk M Hentschel
In this review, we discuss common challenges at the interface between dialysis access planning, prognostication, and patient-centered decision making. Particularly for patients whose survival benefit from dialysis is attenuated by advanced age or other serious illness, knowing the potential complications and anticipated frequency of access procedures is essential for patients and families to be able to conceptualize what life on dialysis will look like. Although starting dialysis with a functioning graft or fistula is associated with reduced infection rates, mortality, hospitalizations, and cost compared with a central venous catheter, these benefits must be weighed against the chance that early access placement in an elderly or seriously ill patient is an unnecessary surgery because the chronic kidney disease never progresses, the patient dies before developing an indication to start dialysis, or, the patient prefers conservative kidney management over dialysis...
January 2023: Seminars in Nephrology
https://read.qxmd.com/read/37563763/improved-nursing-home-end-stage-renal-disease-patient-participation-in-physical-therapy-with-onsite-more-frequent-dialysis
#19
JOURNAL ARTICLE
Eran Y Bellin, William T Markis, Alice M Hellebrand, Christine M Busby, Katy A Wane, Camille R Jordan, Jordan G Ledvina, Steven M Kaplan, Todd R Metzroth, Greg S Williams, Arif Nazir, Nathan W Levin, Allen M Kaufman
INTRODUCTION: For end-stage renal disease (ESRD) patients residing in skilled nursing facilities (SNFs), the logistics and physical exhaustion of life-saving hemodialysis therapy often conflict with rehabilitation goals. Integration of dialysis care with rehabilitation programs in a scalable and cost-efficient manner has been a significant challenge. SNF-resident ESRD patients receiving onsite, more frequent hemodialysis (MFD) have reported rapid post-dialysis recovery. We examined whether such patients have improved Physical Therapy (PT) participation...
August 10, 2023: Hemodialysis International
https://read.qxmd.com/read/37547531/kidney-clinicians-perceptions-of-challenges-and-aspirations-to-improve-end-of-life-care-provision
#20
JOURNAL ARTICLE
Kathryn Ducharlet, Jennifer Weil, Hilton Gock, Jennifer Philip
INTRODUCTION: End-of-life care is an essential part of integrated kidney care. However, renal clinicians' experiences of care provision and perceptions of end-of-life care needs are limited. This study explored renal clinicians' experiences of providing end-of-life care and developed recommendations to improve experiences. METHODS: An exploratory qualitative study using semistructured focus groups and 1 interview was undertaken at 5 kidney services in Victoria, Australia...
August 2023: KI Reports
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