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Contrasting approaches to end of life and palliative care in end stage kidney disease


Koshy, AN and Mace, R and Youl, L and Chanellor, S and Bull, R and Fassett, RG, Contrasting approaches to end of life and palliative care in end stage kidney disease, Indian Journal of Nephrology, 22, (4) pp. 307-309. ISSN 0971-4065 (2012) [Refereed Article]


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Licensed under Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

DOI: doi:10.4103/0971-4065.101263


With increased numbers of the elderly, including nursing home patients, being accepted for end-stage kidney disease (ESKD) management, there is heightened interest and focus on end of life decisions, advanced care planning and directives, withdrawal from dialysis and palliative care in this setting. Despite this, care at the individual patient level can vary greatly. Here, we present two contrasting cases to highlight the importance of early and ongoing involvement of palliative care in patients with ESKD. In the first case, a high quality of life was preserved before the patient died with dignity, with early interdisciplinary palliative care involvement. In the second case there was a long protracted period of poor quality of life prior to death. This was associated with resistance to the involvement of palliative care, mainly from the family. Addressing end of life care issues early in the chronic kidney disease (CKD) trajectory and ensuring patients, their families and health care providers are well informed, may contribute to a better outcome for the patient and their family.

Item Details

Item Type:Refereed Article
Keywords:conservative therapy, kidney failure, morbidity, palliative care
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Nephrology and urology
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Palliative care
UTAS Author:Youl, L (Ms Loren Taylor)
UTAS Author:Bull, R (Professor Rosalind Bull)
ID Code:79614
Year Published:2012
Funding Support:National Health and Medical Research Council (512809)
Deposited By:Health Sciences B
Deposited On:2012-09-25
Last Modified:2018-03-29
Downloads:384 View Download Statistics

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