Palliative care in nephrology
1. Palliative care focuses on treating or alleviating the symptoms and burdens associated with any serious illness.
2. Palliative care can be provided at any time during the course of a serious illness and is not synonymous with hospice, which is a Medicare benefit for patients with a terminal illness or a prognosis less than 6 months.
3. Incorporating palliative care principles into nephrology can help improve symptom management, shared decision making, and advanced care planning for patients with CKD or ESKD.
4. Hemodialysis patients have very high symptom burden and low health-related quality of life. A majority of them report pain, fatigue, and pruritus.
5. Shared decision making is a collaborative process through which the clinician and patient attempt to align goals in order to arrive at a decision that is mutually agreeable to both of them.
6. In situations in which dialysis is thought to have minimal benefit, other treatment options include comprehensive conservative management or a time-limited trial of dialysis.
