End of life care in end-stage kidney disease

Abstract

There is a rise in burden of end-stage renal disease globally and in India. The symptom burden, prognosis, and mortality in chronic kidney disease closely mimics that of cancer. However, the palliative and end of life care needs of these patients are seldom addressed. A consensus opinion statement was developed outlining the provision of end of life care in end-stage kidney disease. Recognition of medical futility, consensus on medical futility, and cessation of potentially inappropriate therapies and medications are the initial steps in providing end of life care. Conducting a family meeting, communicating prognosis, discussing various treatment modalities, negotiating goals of care, shared decision-making, and discussion and documentation of life sustaining treatment are essential aspects of end of life care provision. The provision of end of life care entails assessment and the management of end-stage kidney disease symptoms and the care extends beyond the death of the patient to their families in the bereavement period.

A Review of Clinical Signs and Symptoms of Imminent End-of-Life in Individuals With Advanced Illness

“…Several other studies also report that terminally-ill patients from non-cancer diseases approaching EOL suffer comparably high burdens of disease similar to those dying from advanced cancer (Gore et al, 2000; Lastrucci et al, 2018; Mizuno et al, 2021; Murray et al, 2002; Prabhu et al, 2021; K. Roth et al, 2000).…”

“…Likewise, a large-scale systematic review analysis of 64 original studies that compared symptom prevalence in people with markedly advanced cancer, AIDS, heart disease, chronic pulmonary disease, and renal disease concluded that the common pathway toward death is similar for both cancerous and non-cancerous diseases (Solano et al, 2006). Several other studies also report that terminally-ill patients from non-cancer diseases approaching EOL suffer comparably high burdens of disease similar to those dying from advanced cancer (Gore et al, 2000;Lastrucci et al, 2018;Mizuno et al, 2021;Murray et al, 2002;Prabhu et al, 2021;K. Roth et al, 2000).…”

Beliefs Of Chronic Kidney Disease Patient: A Phenomenology Study

“…Kidney failure is a global health issue that affects the minority and low-income communities. Based on data from the WHO Global Burden of Disease (GBD) it is stated that 5-10 million people die each year due to kidney disease [1]. The prevalence rate of kidney failure in Taiwan is the highest in the world due to a longer life expectancy while the population continues to increase.…”

O manejo de infecções nos pacientes em cuidados paliativos em fase final de vida e processo ativo de morte

“…Entretanto, sabe-se que o oxigênio é útil e traz benefício apenas quando há presença de hipoxemia. Estratégias de manejo não farmacológico, como manter o quarto arejado e fluxo de vento focado no rosto, podem melhorar a sensação de falta de ar (PRABHU et al, 2021).…”