Comprehensive conservative care in end-stage kidney disease

In patients with end-stage kidney disease (ESKD), when there maybe situations where dialysis does not offer benefits in terms of survival or health-related quality of life, dialysis should not be viewed as the default therapy. Such patients can be offered comprehensive conservative care as an altern...

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Bibliographic Details
Published in:Indian journal of palliative care 2021-05, Vol.27 (5), p.11-13, Article S11
Main Authors: Palat, Gayatri, Shenoy, Srinivas, Shetty, Lakshmitha, Vishnubhotla, Sivakumar
Format: Article
Language:English
Subjects:
Clinical decision making
Disease management
Hemodialysis
Kidney diseases
Palliative care
Patient care planning
Quality of life
Review
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Summary:In patients with end-stage kidney disease (ESKD), when there maybe situations where dialysis does not offer benefits in terms of survival or health-related quality of life, dialysis should not be viewed as the default therapy. Such patients can be offered comprehensive conservative care as an alternative to dialysis. Conservative (nondialytic) management of ESKD includes careful attention to fluid balance, treatment of anemia, correction of acidosis and hyperkalemia, blood pressure, and calcium/phosphorus metabolism management and dietary modification. Individualized symptom management and supportive care are crucial to maximize the quality of life. We propose that model of comprehensive conservative care in ESKD should manage both diseases as well as provide supportive care. Facilitating implementation of comprehensive conservative care requires coordination between nephrology and palliative care at patient, professional, administrative, and social levels to maximize benefit with the motto to improve the overall quality of life.
ISSN:0973-1075
1998-3735
0973-1075
DOI:10.4103/ijpc.ijpc_63_21