A Palliative Approach to Dialysis Care: A Patient-Centered Transition to the End of Life

被引：105

作者：

Grubbs, Vanessa ^{[1
,2
]}

Moss, Alvin H. ^{[3
]}

Cohen, Lewis M. ^{[4
]}

Fischer, Michael J. ^{[5
,6
]}

Germain, Michael J. ^{[7
]}

Jassal, S. Vanita ^{[8
]}

Perl, Jeffrey ^{[9
]}

Weiner, Daniel E. ^{[10
]}

Mehrotra, Rajnish ^{[11
]}

机构：

[1] Univ Calif San Francisco, Div Nephrol, San Francisco, CA 94110 USA

[2] San Francisco Gen Hosp, Div Nephrol, San Francisco, CA 94110 USA

[3] W Virginia Univ, Dept Med, Sch Med, Nephrol Sect, Morgantown, WV 26506 USA

[4] Tufts Univ, Sch Med, Baystate Med Ctr, Dept Psychiat, Springfield, MA 01199 USA

[5] Univ Illinois Hosp, Jesse Brown Vet Affairs Med Ctr, Div Nephrol, Chicago, IL USA

[6] Univ Illinois, Hlth Sci Ctr, Chicago, IL 60612 USA

[7] Tufts Univ, Sch Med, Baystate Med Ctr, Div Nephrol, Springfield, MA 01199 USA

[8] Univ Toronto, Univ Hlth Network, Div Nephrol, Toronto, ON, Canada

[9] Univ Toronto, St Michaels Hosp, Div Nephrol, Toronto, ON, Canada

[10] Tufts Med Ctr, Div Nephrol, Boston, MA USA

[11] Univ Washington, Div Nephrol, Seattle, WA 98195 USA

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2014年 / 9卷 / 12期

关键词：

STAGE RENAL-DISEASE; OF-LIFE; PERITONEAL-DIALYSIS; ELDERLY-PATIENTS; HEMODIALYSIS; HOSPICE; NEPHROLOGISTS; SATISFACTION; PREFERENCES; PREVALENCE;

D O I：

10.2215/CJN.00650114

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：

As the importance of providing patient-centered palliative care for patients with advanced illnesses gains attention, standard dialysis delivery may be inconsistent with the goals of care for many patients with ESRD. Many dialysis patients with life expectancy of <1 year may desire a palliative approach to dialysis care, which focuses on aligning patient treatment with patients' informed preferences. This commentary elucidates what comprises a palliative approach to dialysis care and describes its potential and appropriate use. It also reviews the barriers to integrating such an approach into the current clinical paradigm of care and existing infrastructure and outlines system-level changes needed to accommodate such an approach.

引用

页码：2203 / 2209

页数：7

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