Supportive Management in Patients With End-stage Renal Disease: Local Experience in Hong Kong
Article Outline
We report a retrospective observational study on supportive care services in a local renal center. Seventy-four patients who had opted for supportive management after renal replacement therapy assessments in 2008 were included in the study. They were older with more comorbidities than those who had opted for dialysis. Their reported symptoms on subsequent visits were recorded. Patients and their families had a realistic acceptance of death, as reflected by the high preference for do-not-resuscitate orders on their final admission. This demonstrates the importance of structured multidisciplinary renal replacement therapy assessment with advanced care planning in the management of patients with end-stage renal disease.
Key words: end-stage renal disease , palliative care , renal replacement therapy assessment
No full text is available. To read the body of this article, please view the PDF online.
References
- . Annual Data Report 2009. Volume Two: Atlas of End-Stage Renal Disease in the United States. Chapter 2—Incidence and Prevalence . Available at http://www.usrds.org/adr.htm [Date accessed: March 21, 2010]
- . Is there a rationale for rationing chronic dialysis? A hospital based cohort study of factors affecting survival and morbidity . Br Med J . 1999;318:217–223
- . Choosing not to dialyse: evaluation of planned non-dialytic management in a cohort of patients with end stage renal failure . Nephron Clin Pract . 2003;95:c40–c46
- . Functional status of elderly adults before and after initiation of dialysis . N Engl J Med . 2009;361:1539–1547
- . End-of-life care preferences and needs: perceptions of patients with chronic kidney disease . Clin J Am Soc Nephrol . 2010;5:195–204
- Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease . J Am Soc Nephrol . 2006;17:2937–2944 Erratum in: J Am Soc Nephrol 2006;17:3540.
- . Symptom burden and quality of life in end-stage renal disease: a study of 179 patients on dialysis and palliative care . Palliat Med . 2009;23:111–119
- . Comparative pilot study of symptoms and quality of life in cancer patients and patients with end stage renal disease . Palliat Med . 2006;20:631–636
- . Clinical practice guideline on shared decision-making in the appropriate initiation of and withdrawal from dialysis. The Renal Physicians Association and the American Society of Nephrology . J Am Soc Nephrol . 2000;11:1340–1342
- . Hope and advance care planning in patients with end stage renal disease: qualitative interview study . BMJ . 2006;333:886
- . Supportive care for the renal patient . Nephrol Dial Transplant . 2004;19:1357–1360
- . Withholding and withdrawal from dialysis: what we know about how our patients die . Semin Dial . 2007;20:195–199
PII: S1561-5413(10)60006-3
doi:10.1016/S1561-5413(10)60006-3
© 2010 The Hong Kong Society of Nephrology. Published by Elsevier Inc. All rights reserved.
