Conservative management for patients with chronic kidney disease refusing dialysis

Castro, Manuel Carlos Martins

doi:10.1590/2175-8239-jbn-2018-0028

Cited by 21 publications

(19 citation statements)

References 58 publications

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“…The glomerular filtration rate determines the stage of chronic kidney disease and its control affects the course of treatment, since it aims to assess renal function from the clearance of substances that are freely filtered by the glomerulus and do not undergo reabsorption or secretion tubular. Thus, it is shown as an important indicator in conservative treatment and needs to be determined by a specialized health professional who directs the best strategies (41) .…”

Section: Discussionmentioning

confidence: 99%

Terms of specialized nursing language for chronic renal patients undergoing conservative treatment

et al. 2020

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Objectives: to validate the terms of the specialized nursing language used in the care of people with chronic kidney disease undergoing conservative treatment identified in the literature by mapping them with terms of the International Classification for Nursing Practice, version 2019, and representing them by means of a mandala. Methods: descriptive, documentary and methodological study. The terms were collected in 53 scientific articles, standardized and mapped with the terminology. The validation was performed by six nurses through a focus group. The Content Validity Index was used and terms with a value ≥ 0.80 were validated. Results: the normalization resulted in 957 relevant terms, of which 499 were constant and 458 not included in the terminology. Terms were validated when Content Validity Index was between 0.86 and 1.0. Conclusions: the study allowed the validation of terms that will contribute to unify the professional language of nursing in the care of people with chronic kidney disease.

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Section: Discussionmentioning

confidence: 99%

Terms of specialized nursing language for chronic renal patients undergoing conservative treatment

et al. 2020

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“…It is important to have an articulated and complementary relationship "between the different professions, since knowledge construction and best care practices" (21) require national and international interdisciplinary and multidisciplinary support networks in order to humanize and fully meet the needs of the person in a dialogical perspective (22)(23) . However, the confrontations imposed on nurses in the context of the nephrology service do not refer to the patient itself, but to complex interpersonal relationships, which may affect all therapy, even compromising the quality of the care provided (24) .…”

Section: Discussionmentioning

confidence: 99%

Integralidade do cuidado-permanência na nefrologia: concepções de enfermeiros

Santos

Araújo

Gómez-Torres

et al. 2019

Rev. esc. enferm. USP

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RESUMO Objetivo: Discutir como se dá a integralidade do cuidado-permanência à pessoa em tratamento na nefrologia. Método: Estudo qualitativo, exploratório e descritivo, ancorado na Sociopoética, realizado no primeiro semestre de 2018, no Rio de Janeiro, Brasil, com enfermeiros de serviços de nefrologia. Os dados foram produzidos após a aplicação da técnica criativa com desenhos e colagens e da enunciação gravada sobre os significados e significantes de cuidado-permanência. A análise foi realizada com base nos princípios da Sociopoética, a partir das concepções filosóficas dos grupos pesquisadores. Resultados: Participaram 15 enfermeiros, com experiência em serviços de nefrologia. Quatro eixos conceituais foram compartilhados e referem-se a: cuidado integral; cuidado complexo; cuidado contínuo; e cuidado inclusivo, que considera, além do paciente, sua família, equipe, sociedade e seu contexto. Conclusão: A reflexão filosófica sobre o cuidado ao Ser humano implica considerar as dimensões do físico, emocional, individual, mas também suas revoluções micro e macromoleculares do existir como ser social. A natureza do conhecimento a partir da produção lúdica permitiu reflexão e consciência, o tempo todo e a todo o tempo, sobre a integralidade do cuidado por enfermeiros na nefrologia.

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“…Approaches to managing diabetes vary. Individuals previously on insulin therapy are often required to decrease dosages, since insulin is metabolized in the renal tubular cells and has its half-life prolonged in CKD G5 [153]. A recent study, among a cohort of US veterans, shows the need for different glycemic strategies based on whether there are plans to transition to dialysis versus pursuing comprehensive conservative care among DKD patients by relating mortality to different glycated hemoglobin targets in each of the groups [154].…”

Section: Patients With Dkd Who Could Benefit From Comprehensive Conservative Carementioning

confidence: 99%

Management of Kidney Failure in Patients with Diabetes Mellitus: What Are the Best Options?

Fuster

Craver

Pino

et al. 2021

JCM

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Diabetic kidney disease (DKD) is the most frequent cause of kidney failure (KF). There are large variations in the incidence rates of kidney replacement therapy (KRT). Late referral to nephrology services has been associated with an increased risk of adverse outcomes. In many countries, when patients reach severely reduced glomerular filtration rate (GFR), they are managed by multidisciplinary teams led by nephrologists. In these clinics, efforts will continue to halt chronic kidney disease (CKD) progression and to prevent cardiovascular mortality and morbidity. In patients with diabetes and severely reduced GFR and KF, treating hyperglycemia is a challenge, since some drugs are contraindicated and most of them require dose adjustments. Even more, a decision-making process will help in deciding whether the patient would prefer comprehensive conservative care or KRT. On many occasions, this decision will be conditioned by diabetes mellitus itself. Effective education should cover the necessary information for the patient and family to answer these questions: 1. Should I go for KRT or not? 2. If the answer is KRT, dialysis and/or transplantation? 3. Dialysis at home or in center? 4. If dialysis at home, peritoneal dialysis or home hemodialysis? 5. If transplantation is desired, discuss the options of whether the donation would be from a living or deceased donor. This review addresses the determinant factors with an impact on DKD, aiming to shed light on the specific needs that arise in the management and recommendations on how to achieve a comprehensive approach to the diabetic patient with chronic kidney disease.

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Conservative management for patients with chronic kidney disease refusing dialysis

Cited by 21 publications

References 58 publications

Terms of specialized nursing language for chronic renal patients undergoing conservative treatment

Terms of specialized nursing language for chronic renal patients undergoing conservative treatment

Integralidade do cuidado-permanência na nefrologia: concepções de enfermeiros

Management of Kidney Failure in Patients with Diabetes Mellitus: What Are the Best Options?

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