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Supportive care for end-stage kidney disease: an integral part of kidney services across a range of income settings around the world.

Davies

Authors



Abstract

A key component of treatment for all people with advanced kidney disease is supportive care, which aims to improve quality of life and can be provided alongside therapies intended to prolong life, such as dialysis. This article addresses the key considerations of supportive care as part of integrated end-stage kidney disease care, with particular attention paid to programs in low- and middle-income countries. Supportive care should be an integrated component of care for patients with advanced chronic kidney disease, patients receiving kidney replacement therapy (KRT), and patients receiving non-KRT conservative care. Five themes are identified: improving information on prognosis and support, developing context-specific evidence, establishing appropriate metrics for monitoring care, clearly communicating the role of supportive care, and integrating supportive care into existing health care infrastructures. This report explores some general aspects of these 5 domains, before exploring their consequences in 4 health care situations/settings: in people approaching end-stage kidney disease in high-income countries and in low- and middle-income countries, and in people discontinuing KRT in high-income countries and in low- and middle-income countries.

Acceptance Date Nov 7, 2019
Publication Date Feb 19, 2020
Publicly Available Date Mar 29, 2024
Journal Kidney International Supplements
Print ISSN 2157-1724
Publisher Nature Publishing Group
Pages e86 - e94
DOI https://doi.org/10.1016/j.kisu.2019.11.008
Keywords conservative care, end-stage kidney disease, palliative care, supportive care
Publisher URL https://www.sciencedirect.com/science/article/pii/S215717161930022X?via%3Dihub