TY  - CHAP
M1  - Book, Section
TI  - Palliative Care Nephrology
A1  - Koncicki, Holly M.
A2  - Lerma, Edgar V.
A2  - Rosner, Mitchell H.
A2  - Perazella, Mark A.
PY  - 2017
T2  - CURRENT Diagnosis & Treatment: Nephrology & Hypertension, 2e
AB  - Palliative  care  is  an  approach  to  patient  care  in  which  there  is  a  focus  on  improving  the  quality  of  life  of  patients  and  families  living  with  complex  or  life  limiting  illnesses  by  ensuring  that  treatment  is  consistent  with  patient  goals  and  values,  as  well  as  prompt  identification  and  aggressive  treatment  of  symptoms.  It  is  often  inappropriately  interchanged  with  hospice  or  end  of  life  care,  though  this  is  only  a  small  portion  of  palliative  care.  Unlike  hospice  care,  which  is  offered  in  the  last  6  months  of  life,  palliative  care  can  be  incorporated  early,  at  any  stage  of  a  serious  or  life  limiting  illness  and  can  be  offered  concurrently  with  curative  or  disease  specific  therapies  (Figure  58–1).  Though  use  has  been  well  established  in  cancer  and  congestive  heart  disease,  recognition  of  the  needs  in  patients  with  chronic  kidney  disease  (CKD)  has  led  to  a  growing  interest  in  this  field  of  palliative  care  nephrology.  CKD  is  a  life-limiting  condition  that  will  necessitate  the  need  for  patients,  family  members,  and  care  providers  to  engage  in  discussions  regarding  treatment  decisions.  As  the  number  of  patients  with  CKD  increases,  and  as  incident  dialysis  patients  are  ageing,  the  demand  for  palliative  care  will  soon  overwhelm  the  current  availability  of  specialty  trained  physicians.  There  are  several  important  palliative  care  skills  that  specialty  providers  should  be  sufficient  in,  in  order  to  streamline  care.  These  skills  include  the  ability  to  engage  in  shared  decision  making  including  prognostication  of  patients  with  CKD  and  discussions  regarding  modality  selection  including  conservative  therapy,  symptom  identification  and  basic  management,  and  laying  the  foundation  for  advanced  care  planning.  Integration  of  nephrology  and  palliative  care  exists  in  certain  areas  of  the  world  in  which  conservative  care,  or  supportive  care  clinics  are  well  established  for  caring  for  patients  with  CKD,  some  of  who  may  opt  for  nondialysis,  or  conservative  treatment  of  their  advanced  kidney  disease.  Referral  to,  or  consultation  with  palliative  care  physicians  is  appropriate  if  the  aforementioned  needs  are  unable  to  be  met  by  the  nephrology  provider,  for  the  complicated  patient  or  family  dynamic,  or  for  assistance  with  discussions  and  transitions  for  end  of  life  care  including  hospice.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/17
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1149117428
ER  -