Kidney Supportive Care: Core Curriculum 2020

Samantha L. Gelfand, Jennifer S. Scherer, Holly M. Koncicki

Research output: Contribution to journalReview articlepeer-review

51 Scopus citations

Abstract

Kidney supportive care is the application of palliative medicine principles and practices to patients with kidney disease. The goal is alleviation of suffering through treatment of symptoms, empathic communication, and support for psychosocial distress. Kidney supportive care includes primary palliative care provided by nephrology teams, as well as referral of patients with complex distress for comanagement by an interprofessional specialty palliative care team, when available. The team may include physicians, nurses, social workers, chaplains, and dieticians. Comanagement with nephrologists offers an additional layer of support to patients and families as prognostic awareness, patient preferences, and care decisions are explored. Kidney supportive care can be offered to patients experiencing acute kidney injury or chronic kidney disease, including those with kidney failure treated by kidney replacement therapy (dialysis and transplantation). Kidney supportive care includes but is not limited to end-of-life care. This installment of the Core Curriculum in Nephrology outlines several practical applications of kidney supportive care, with a focus on the nephrologist's approach to symptom management, active medical management of kidney failure without dialysis (also known as comprehensive conservative care), acute kidney injury in seriously ill patients, and withdrawal from dialysis.

Original languageEnglish
Pages (from-to)793-806
Number of pages14
JournalAmerican Journal of Kidney Diseases
Volume75
Issue number5
DOIs
StatePublished - May 2020

Keywords

  • Kidney supportive care/renal supportive care/palliative care
  • conservative care/comprehensive conservative care/active medical management/maximal medical management
  • dialysis withdrawal/withholding dialysis/stopping dialysis
  • end-of-life decision making
  • shared decision-making/informed consent/patient-centered care/prognostic awareness
  • symptom management/symptom burden

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