TY - JOUR
T1 - Kidney Supportive Care
T2 - Core Curriculum 2020
AU - Gelfand, Samantha L.
AU - Scherer, Jennifer S.
AU - Koncicki, Holly M.
N1 - Funding Information:
Samantha L. Gelfand, MD, Jennifer S. Scherer, MD, and Holly M. Koncicki, MD, MS. Dr Scherer acknowledges support from the Cambia Health Foundation and National Kidney Foundation. The funders did not have any role in defining the content of this article. The authors declare that they have no other relevant financial interests. Received June 27, 2019, in response to an invitation from the journal. Evaluated by 2 external peer reviewers and a member of the Feature Advisory Board, with direct editorial input from the Feature Editor and a Deputy Editor. Accepted in revised form October 10, 2019.
Funding Information:
Dr Scherer acknowledges support from the Cambia Health Foundation and National Kidney Foundation . The funders did not have any role in defining the content of this article.
Publisher Copyright:
© 2019 National Kidney Foundation, Inc.
PY - 2020/5
Y1 - 2020/5
N2 - 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.
AB - 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.
KW - Kidney supportive care/renal supportive care/palliative care
KW - conservative care/comprehensive conservative care/active medical management/maximal medical management
KW - dialysis withdrawal/withholding dialysis/stopping dialysis
KW - end-of-life decision making
KW - shared decision-making/informed consent/patient-centered care/prognostic awareness
KW - symptom management/symptom burden
UR - http://www.scopus.com/inward/record.url?scp=85081610963&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2019.10.016
DO - 10.1053/j.ajkd.2019.10.016
M3 - Review article
C2 - 32173108
AN - SCOPUS:85081610963
SN - 0272-6386
VL - 75
SP - 793
EP - 806
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 5
ER -