Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care

被引:427
作者
Davison, Sara N. [1 ]
Levin, Adeera [2 ]
Moss, Alvin H. [3 ]
Jha, Vivekanand [4 ,5 ]
Brown, Edwina A. [6 ]
Brennan, Frank [7 ]
Murtagh, Fliss E. M. [8 ]
Naicker, Saraladevi [9 ]
Germain, Michael J. [10 ]
O'Donoghue, Donal J. [11 ]
Morton, Rachael L. [12 ,13 ]
Obrador, Gregorio T. [14 ]
机构
[1] Univ Alberta, Dept Med, Div Nephrol & Immunol, Edmonton, AB T6G 2G3, Canada
[2] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada
[3] W Virginia Univ, Dept Med, Morgantown, WV 26506 USA
[4] Postgrad Inst Med Educ & Res, Dept Nephrol, Chandigarh 160012, India
[5] George Inst Global Hlth, New Delhi, India
[6] Hammersmith Hosp, Imperial Coll Renal & Transplant Ctr, London, England
[7] St George Hosp, Dept Palliat Care, Sydney, NSW, Australia
[8] Kings Coll London, Dept Palliat Care Policy & Rehabil, Cicely Saunders Inst, London WC2R 2LS, England
[9] Univ Witwatersrand, Fac Hlth Sci, Dept Internal Med, Div Nephrol, Johannesburg, South Africa
[10] Tufts Univ, Sch Med, Baystate Med Ctr, Div Nephrol, Springfield, MA 01199 USA
[11] Salford Royal NHS Fdn Trust, Renal Unit, Salford, Lancs, England
[12] Univ Sydney, Sydney Med Sch, Sch Publ Hlth, Sydney, NSW 2006, Australia
[13] Univ Oxford, Nuffield Dept Populat Hlth, Hlth Econ Res Ctr, Oxford, England
[14] Univ Panamericana, Sch Med, Mexico City, DF, Mexico
基金
英国医学研究理事会;
关键词
chronic kidney disease; conservative care; palliative care; supportive care; symptoms; withdrawal of dialysis; RESTLESS LEGS SYNDROME; STAGE RENAL-DISEASE; OF-LIFE CARE; AMBULATORY PERITONEAL-DIALYSIS; CHRONIC-HEMODIALYSIS PATIENTS; SYMPTOM ASSESSMENT SYSTEM; UREMIC PRURITUS; SLEEP DISORDERS; PALLIATIVE CARE; CONSERVATIVE MANAGEMENT;
D O I
10.1038/ki.2015.110
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Patients with advanced chronic kidney disease (CKD) have a high burden of physical and psychosocial symptoms, poor outcomes, and high costs of care. Current paradigms of care for this highly vulnerable population are variable, prognostic and assessment tools are limited, and quality of care, particularly regarding conservative and palliative care, is suboptimal. The KDIGO Controversies Conference on Supportive Care in CKD reviewed the current state of knowledge in order to define a roadmap to guide clinical and research activities focused on improving the outcomes of people living with advanced CKD, including those on dialysis. An international group of multidisciplinary experts in CKD, palliative care, methodology, economics, and education identified the key issues related to palliative care in this population. The conference led to a working plan to address outstanding issues in this arena, and this executive summary serves as an output to guide future work, including the development of globally applicable guidelines.
引用
收藏
页码:447 / 459
页数:13
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