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Advance Care Planning, Renal Conservative and Palliative Care

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319 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Kai Ming Chow, Cheuk Chun Szeto, Agnes Shin Man Choy, Jack Kit Chung Ng, Alice Ka Wai Mok, Chi Bon Leung, Philip Kam Tao Li
BACKGROUND: Despite the increasing use of erythropoiesis-stimulating agent (ESA) in patients receiving dialysis, few studies have examined the benefits of ESA for patients with chronic kidney disease receiving palliative care. OBJECTIVE: We designed a retrospective observational study to evaluate the effect of ESA in treating anemia of renal disease among adult patients receiving palliative care instead of dialysis. The primary objective was to assess whether ESA can reduce the transfusion burden and hospitalization...
March 7, 2019: American Journal of Hospice & Palliative Care
Chia-Ter Chao, Jenq-Wen Huang, Chih-Kang Chiang, Kuan-Yu Hung
AIM: Laboratory deficit-based frailty index (LFI) exhibited outcome-prediction ability in the elderly, but not in those with end-stage renal disease (ESRD). We hypothesized that LFI results might have outcome correlation and correlate closely with other instruments in ESRD patients. METHODS: We prospectively enrolled ESRD patients between 2014 and 2015 and administered self-report frailty instruments (Strawbridge questionnaire [SQ], Edmonton frail scale [EFS], Groningen frailty indicator [GFI], Tilburg frailty indicator [TFI], G8 questionnaire, and FRAIL scale), Cardiovascular Health Study [CHS], with two types of LFI calculated...
March 5, 2019: Nephrology
María Victoria Rubio Rubio, Luis Miguel Lou Arnal, José Antonio Gimeno Orna, Paula Munguía Navarro, Alex Gutiérrez-Dalmau, Elena Lambán Ibor, Javier Paúl Ramos, Raquel Pernaute Lavilla, Belén Campos Gutiérrez, Alberto San Juan Hernández-Franch
INTRODUCTION: Conservative Management (CM) has become a therapeutic option in Advanced Chronic Kidney Disease in the elderly. However, there is a lack of evidence about prognosis of these patients in terms of survival and health related quality of life (HRQoL). OBJECTIVE: Establish predictive variables associated with mortality and analyse HRQoL in CM patients. PATIENTS AND METHODS: Prospective cohort study. An assessment of renal function parameters and a comprehensive geriatric assessment were made, including: analysis of comorbidity, functional, cognitive, fragility, nutritional, social and HRQoL status...
March 2019: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Kirsty Boyd, Sebastien Moine, Scott A Murray, Deborah Bowman, Nicole Brun
No abstract text is available yet for this article.
February 28, 2019: BMJ: British Medical Journal
Stefanie Danielle Piña-Escudero, Roberto De Jesús García-Avilés, Armando Iván Fajardo-Juárez, César Urtiz López, Ana Karene Del Moral-Trejo, Pedro Manuel Ramírez-Ambriz, Alejandro Tovar-Serrano, García-Lara Juan Miguel Antonio
Aim: The aim of the study is to assess which factors are associated with self-efficacy for making these decisions in surrogates of end-stage kidney disease patients. Materials and Methods: Cross-sectional study conducted in the hemodialysis clinic of a private hospital in Mexico City. A total of 124 surrogates of patients in hemodialysis were included in the study. Self-efficacy for decision-making was assessed with the Family Decision-Making Self-Efficacy Scale...
January 2019: Indian Journal of Palliative Care
Sara N Davison, Beth Tupala, Betty Ann Wasylynuk, Valerie Siu, Aynharan Sinnarajah, Jean Triscott
Conservative kidney management is increasingly accepted as an appropriate treatment option for patients with eGFR category 5 CKD who are unlikely to benefit from dialysis and/or who choose a nondialysis care option. However, there remains great variation in the delivery of their care. As part of the development of a conservative kidney management pathway that is undergoing evaluation, a set of recommendations specific to conservative kidney management for managing the complications of CKD and common symptoms was developed...
February 28, 2019: Clinical Journal of the American Society of Nephrology: CJASN
Angelika Albaladejo
No abstract text is available yet for this article.
February 26, 2019: BMJ: British Medical Journal
Ann E Vandenberg, C Barrett Bowling, Olufunmilola Adisa, Abyalew Sahlie, Leigh Nadel, Janice Lea, Laura C Plantinga
OBJECTIVE: To examine concordance and tensions in values among stakeholder groups across the shared decision making process for end-stage renal disease patients treated with hemodialysis. METHODS: A thematic analysis of transcripts from three stakeholder groups: hemodialysis patients (2 groups, n = 17), nephrologists (1 group, n = 9), and non-physician providers (dietitians, social workers, and registered nurses) (1 group, n = 8). A framework of decision-making components (communication, information, decision, behavior, and outcome) guided analysis of values within and across groups...
February 11, 2019: Patient Education and Counseling
Erica Perry, Sally Joy, Richard Swartz
No abstract text is available yet for this article.
February 19, 2019: Journal of the American Society of Nephrology: JASN
Zlatana Nenova, John Hotchkiss
BACKGROUND: Chronic kidney disease palliative care guidelines would benefit from more diverse and objectively defined health status measures. AIM: The aim is to identify high-risk patients from administrative data and facilitate timely and uniform palliative care involvement. DESIGN: It is a retrospective cohort study. SETTING/PARTICIPANTS: In total, 45,368 Veterans, with chronic kidney disease Stage 3, 4, or 5, were monitored for up to 6 years and categorized into three groups, based on whether they died, started dialysis, or avoided both outcomes...
February 12, 2019: Palliative Medicine
James B Wetmore, Nicholas S Roetker, David T Gilbertson, Jiannong Liu
INTRODUCTION: Whether and how factors associated with elective hemodialysis withdrawal differ from those associated with non-withdrawal death soon after maintenance hemodialysis initiation have not been well studied. METHODS: A retrospective cohort analysis was performed using USRDS data from 2011 to 2014. Patients were randomly categorized 2:1 into training and validation samples. Elective withdrawal deaths were identified using the Death Notification form. Multinomial logistic regression was used to fit a prediction model for three outcome categories (withdrawal, non-withdrawal death, survival at 6 months) as a function of demographic, comorbidity, and functional status...
February 11, 2019: Hemodialysis International
Kyla L Naylor, S Joseph Kim, Eric McArthur, Amit X Garg, Megan K McCallum, Gregory A Knoll
RATIONALE & OBJECTIVE: The mortality rate is high among dialysis patients, but how this compares with other diseases such as cancer is poorly understood. We compared the survival of maintenance dialysis patients with that for patients with common cancers to enhance the understanding of the burden of end-stage kidney disease. STUDY DESIGN: Population-based cohort study. SETTING & PARTICIPANTS: 33,500 incident maintenance dialysis patients in Ontario, Canada, and 532,452 incident patients with cancer (women: breast, colorectal, lung, or pancreas; men: prostate, colorectal, lung, or pancreas) from 1997 to 2015 using administrative health care databases...
January 28, 2019: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Daniel Y Lam, Jennifer S Scherer, Mark Brown, Vanessa Grubbs, Jane O Schell
Kidney palliative care is a growing discipline within nephrology. Kidney palliative care specifically addresses the stress and burden of advanced kidney disease through the provision of expert symptom management, caregiver support, and advance care planning with the goal of optimizing quality of life for patients and families. The integration of palliative care principles is necessary to address the multidimensional impact of advanced kidney disease on patients. In particular, patients with advanced kidney disease have a high symptom burden and experience greater intensity of care at the end of life compared with other chronic serious illnesses...
February 6, 2019: Clinical Journal of the American Society of Nephrology: CJASN
Laura Finn, Sonia Malhotra
Palliative Care and its medical subspecialty, known as Palliative Medicine, is the care of anyone with a serious illness. This emerging field includes Hospice and comfort care, however, it is not limited to end-of-life care. Examples of the types of serious illness that Palliative Medicine clinicians care for include and are not limited to hematologic and oncologic diseases, such as cancer, advanced heart and lung diseases (e.g., congestive heart failure and chronic obstructive pulmonary disorder), advanced liver and kidney diseases, and advanced neurologic illnesses (e...
February 1, 2019: Healthcare (Basel, Switzerland)
Lucy Ellen Selman, Katherine Bristowe, Irene J Higginson, Fliss E M Murtagh
BACKGROUND: Older people with advanced kidney disease require information and support from clinicians when deciding whether to have dialysis or conservative (non-dialysis) care. There is evidence that communication practices, information provision and treatment rates vary widely across renal units. However, experiences of communicating with clinicians among patients receiving conservative care are poorly understood. This evidence is essential to ensure support is patient-centred and equitable...
February 4, 2019: BMC Nephrology
Gang Jee Ko, Yoshitsugu Obi, Tae Ik Chang, Melissa Soohoo, Rieko Eriguchi, Soo Jeong Choi, Daniel L Gillen, Csaba P Kovesdy, Elani Streja, Kamyar Kalantar-Zadeh, Connie M Rhee
OBJECTIVES: Among kidney disease patients ≥80 years progressing to end-stage renal disease, there is growing interest in conservative nondialytic management approaches. However, among those who have initiated hemodialysis, little is known about the impact of withdrawal from dialysis on mortality, nor the patient characteristics associated with withdrawal from dialysis. STUDY DESIGN: Historical cohort study. SETTING AND PARTICIPANTS: We examined 133,162 incident hemodialysis patients receiving care within a large national dialysis organization from 2007 to 2011...
January 25, 2019: Journal of the American Medical Directors Association
Cédric Villain, Denis Fouque
No abstract text is available yet for this article.
January 24, 2019: Nephrology, Dialysis, Transplantation
Keren Ladin, Alexander K Smith
No abstract text is available yet for this article.
January 22, 2019: JAMA Internal Medicine
Susan P Y Wong, Lynne V McFarland, Chuan-Fen Liu, Ryan J Laundry, Paul L Hebert, Ann M O'Hare
Importance: Although maintenance dialysis is a treatment choice with potential benefits and harms, little is known about care practices for patients with advanced chronic kidney disease who forgo this treatment. Objective: To describe how decisions not to start dialysis unfold in the clinical setting. Design, Setting and Participants: A qualitative study was performed of documentation in the electronic medical records of 851 adults receiving care from the US Veterans Health Administration between January 1, 2000, and October 1, 2011, who had chosen not to start dialysis...
January 22, 2019: JAMA Internal Medicine
Fahad Saeed, Muhammad Adil Sardar, Sara N Davison, Haris Murad, Paul R Duberstein, Timothy Edward Quill
BACKGROUND: Few studies have explored dialysis patients' perspectives on dialysis decision-making and end-of-life-care (EoLC) preferences. We surveyed a racially diverse cohort of maintenance dialysis patients in the Cleveland, OH, USA, metropolitan area. MATERIALS AND METHODS: In this cross-sectional study, we administered a 41-item questionnaire to 450 adult chronic dialysis patients. Items assessed patients' knowledge of their kidney disease as well as their attitudes toward chronic kidney disease (CKD) treatment issues and EoLC issues...
January 21, 2019: Clinical Nephrology
2019-01-23 12:07:13
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