Supportive Care: Comprehensive Conservative Care in End-Stage Kidney Disease.
Identifieur interne : 001828 ( PubMed/Corpus ); précédent : 001827; suivant : 001829Supportive Care: Comprehensive Conservative Care in End-Stage Kidney Disease.
Auteurs : Fliss E M. Murtagh ; Aine Burns ; Olivier Moranne ; Rachael L. Morton ; Saraladevi NaickerSource :
- Clinical journal of the American Society of Nephrology : CJASN [ 1555-905X ] ; 2016.
Abstract
Comprehensive conservative (nondialytic) kidney care is widely recognized and delivered but until recently, has not been clearly defined. We provide a clear definition of comprehensive conservative care. This includes interventions to delay progression of kidney disease and minimize complications as well as detailed communication, shared decision making, advance care planning, and psychologic and family support. It does not include dialysis. Limited epidemiologic evidence from Australia and Canada indicates that, for every new person diagnosed with ESRD who receives dialysis or transplant, there is one new person who is managed conservatively (either actively or not). For older patients (those >75 or 80 years old) who have higher levels of comorbidity (such as diabetes and heart disease) and poorer functional status, the survival advantage of dialysis may be limited, and comprehensive conservative management may be considered; however, robust comparative evidence remains limited. Considerations of symptoms, quality of life, and hospital-free days are as or sometimes more important for patients and families than survival. There is some evidence that communication about possible conservative management options is generally insufficient, even where comprehensive conservative care pathways are already established. Symptom control and the cost-effectiveness of interventions are addressed in the companion papers within this Moving Points in Nephrology series. There is almost no evidence about which models of care and which interventions might be most beneficial in this population; future research on these areas is much needed. Meanwhile, consistency in definition of comprehensive conservative care and basing interventions on existing evidence about survival, symptoms, quality of life, and experience will maximize patient-centered and holistic care.
DOI: 10.2215/CJN.04840516
PubMed: 27510453
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Murtagh</name><affiliation><nlm:affiliation>Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom; fliss.murtagh@kcl.ac.uk.</nlm:affiliation></affiliation></author><author><name sortKey="Burns, Aine" sort="Burns, Aine" uniqKey="Burns A" first="Aine" last="Burns">Aine Burns</name><affiliation><nlm:affiliation>Department of Nephrology, Royal Free Hospital National Health Service Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Moranne, Olivier" sort="Moranne, Olivier" uniqKey="Moranne O" first="Olivier" last="Moranne">Olivier Moranne</name><affiliation><nlm:affiliation>Institut Universitaire de Recherche Clinique, EA2415, Epidémiologie, Biostatistiques et santé publique, Faculté de Médecine, Université de Montpellier, Montpellier, France.</nlm:affiliation></affiliation></author><author><name sortKey="Morton, Rachael L" sort="Morton, Rachael L" uniqKey="Morton R" first="Rachael L" last="Morton">Rachael L. Morton</name><affiliation><nlm:affiliation>National Health and Medical Research Centre Clinical Trials Centre, University of Sydney, Sydney, Australia; and.</nlm:affiliation></affiliation></author><author><name sortKey="Naicker, Saraladevi" sort="Naicker, Saraladevi" uniqKey="Naicker S" first="Saraladevi" last="Naicker">Saraladevi Naicker</name><affiliation><nlm:affiliation>Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27510453</idno><idno type="pmid">27510453</idno><idno type="doi">10.2215/CJN.04840516</idno><idno type="wicri:Area/PubMed/Corpus">001828</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001828</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Supportive Care: Comprehensive Conservative Care in End-Stage Kidney Disease.</title><author><name sortKey="Murtagh, Fliss E M" sort="Murtagh, Fliss E M" uniqKey="Murtagh F" first="Fliss E M" last="Murtagh">Fliss E M. Murtagh</name><affiliation><nlm:affiliation>Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom; fliss.murtagh@kcl.ac.uk.</nlm:affiliation></affiliation></author><author><name sortKey="Burns, Aine" sort="Burns, Aine" uniqKey="Burns A" first="Aine" last="Burns">Aine Burns</name><affiliation><nlm:affiliation>Department of Nephrology, Royal Free Hospital National Health Service Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Moranne, Olivier" sort="Moranne, Olivier" uniqKey="Moranne O" first="Olivier" last="Moranne">Olivier Moranne</name><affiliation><nlm:affiliation>Institut Universitaire de Recherche Clinique, EA2415, Epidémiologie, Biostatistiques et santé publique, Faculté de Médecine, Université de Montpellier, Montpellier, France.</nlm:affiliation></affiliation></author><author><name sortKey="Morton, Rachael L" sort="Morton, Rachael L" uniqKey="Morton R" first="Rachael L" last="Morton">Rachael L. Morton</name><affiliation><nlm:affiliation>National Health and Medical Research Centre Clinical Trials Centre, University of Sydney, Sydney, Australia; and.</nlm:affiliation></affiliation></author><author><name sortKey="Naicker, Saraladevi" sort="Naicker, Saraladevi" uniqKey="Naicker S" first="Saraladevi" last="Naicker">Saraladevi Naicker</name><affiliation><nlm:affiliation>Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical journal of the American Society of Nephrology : CJASN</title><idno type="eISSN">1555-905X</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Comprehensive conservative (nondialytic) kidney care is widely recognized and delivered but until recently, has not been clearly defined. We provide a clear definition of comprehensive conservative care. This includes interventions to delay progression of kidney disease and minimize complications as well as detailed communication, shared decision making, advance care planning, and psychologic and family support. It does not include dialysis. Limited epidemiologic evidence from Australia and Canada indicates that, for every new person diagnosed with ESRD who receives dialysis or transplant, there is one new person who is managed conservatively (either actively or not). For older patients (those >75 or 80 years old) who have higher levels of comorbidity (such as diabetes and heart disease) and poorer functional status, the survival advantage of dialysis may be limited, and comprehensive conservative management may be considered; however, robust comparative evidence remains limited. Considerations of symptoms, quality of life, and hospital-free days are as or sometimes more important for patients and families than survival. There is some evidence that communication about possible conservative management options is generally insufficient, even where comprehensive conservative care pathways are already established. Symptom control and the cost-effectiveness of interventions are addressed in the companion papers within this Moving Points in Nephrology series. There is almost no evidence about which models of care and which interventions might be most beneficial in this population; future research on these areas is much needed. Meanwhile, consistency in definition of comprehensive conservative care and basing interventions on existing evidence about survival, symptoms, quality of life, and experience will maximize patient-centered and holistic care.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">27510453</PMID><DateCreated><Year>2016</Year><Month>08</Month><Day>11</Day></DateCreated><DateRevised><Year>2017</Year><Month>04</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1555-905X</ISSN><JournalIssue CitedMedium="Internet"><Volume>11</Volume><Issue>10</Issue><PubDate><Year>2016</Year><Month>Oct</Month><Day>07</Day></PubDate></JournalIssue><Title>Clinical journal of the American Society of Nephrology : CJASN</Title><ISOAbbreviation>Clin J Am Soc Nephrol</ISOAbbreviation></Journal><ArticleTitle>Supportive Care: Comprehensive Conservative Care in End-Stage Kidney Disease.</ArticleTitle><Pagination><MedlinePgn>1909-1914</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2215/CJN.04840516</ELocationID><Abstract><AbstractText>Comprehensive conservative (nondialytic) kidney care is widely recognized and delivered but until recently, has not been clearly defined. We provide a clear definition of comprehensive conservative care. This includes interventions to delay progression of kidney disease and minimize complications as well as detailed communication, shared decision making, advance care planning, and psychologic and family support. It does not include dialysis. Limited epidemiologic evidence from Australia and Canada indicates that, for every new person diagnosed with ESRD who receives dialysis or transplant, there is one new person who is managed conservatively (either actively or not). For older patients (those >75 or 80 years old) who have higher levels of comorbidity (such as diabetes and heart disease) and poorer functional status, the survival advantage of dialysis may be limited, and comprehensive conservative management may be considered; however, robust comparative evidence remains limited. Considerations of symptoms, quality of life, and hospital-free days are as or sometimes more important for patients and families than survival. There is some evidence that communication about possible conservative management options is generally insufficient, even where comprehensive conservative care pathways are already established. Symptom control and the cost-effectiveness of interventions are addressed in the companion papers within this Moving Points in Nephrology series. There is almost no evidence about which models of care and which interventions might be most beneficial in this population; future research on these areas is much needed. Meanwhile, consistency in definition of comprehensive conservative care and basing interventions on existing evidence about survival, symptoms, quality of life, and experience will maximize patient-centered and holistic care.</AbstractText><CopyrightInformation>Copyright © 2016 by the American Society of Nephrology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Murtagh</LastName><ForeName>Fliss E M</ForeName><Initials>FE</Initials><AffiliationInfo><Affiliation>Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom; fliss.murtagh@kcl.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Burns</LastName><ForeName>Aine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Royal Free Hospital National Health Service Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moranne</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Institut Universitaire de Recherche Clinique, EA2415, Epidémiologie, Biostatistiques et santé publique, Faculté de Médecine, Université de Montpellier, Montpellier, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Nephrology and Dialysis Department, Centre Hospitalier Universitaire de Nimes, Nimes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morton</LastName><ForeName>Rachael L</ForeName><Initials>RL</Initials><AffiliationInfo><Affiliation>National Health and Medical Research Centre Clinical Trials Centre, University of Sydney, Sydney, Australia; and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Naicker</LastName><ForeName>Saraladevi</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>08</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin J Am Soc Nephrol</MedlineTA><NlmUniqueID>101271570</NlmUniqueID><ISSNLinking>1555-9041</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Advance Care Planning</Keyword><Keyword MajorTopicYN="N">Australia</Keyword><Keyword MajorTopicYN="N">Canada</Keyword><Keyword MajorTopicYN="N">Chronic</Keyword><Keyword MajorTopicYN="N">Comorbidity</Keyword><Keyword MajorTopicYN="N">Heart Diseases</Keyword><Keyword MajorTopicYN="N">Humans</Keyword><Keyword MajorTopicYN="N">Kidney Failure</Keyword><Keyword MajorTopicYN="N">Prevalence</Keyword><Keyword MajorTopicYN="N">Renal Insufficiency</Keyword><Keyword MajorTopicYN="N">chronic kidney disease</Keyword><Keyword MajorTopicYN="N">conservative care</Keyword><Keyword MajorTopicYN="N">diabetes mellitus</Keyword><Keyword MajorTopicYN="N">palliative care</Keyword><Keyword MajorTopicYN="N">patient-centered care</Keyword><Keyword MajorTopicYN="N">quality of life</Keyword><Keyword MajorTopicYN="N">renal dialysis</Keyword><Keyword MajorTopicYN="N">supportive care</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>8</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>8</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>8</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27510453</ArticleId><ArticleId IdType="pii">CJN.04840516</ArticleId><ArticleId IdType="doi">10.2215/CJN.04840516</ArticleId><ArticleId IdType="pmc">PMC5053791</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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