Indian Journal of Palliative Care
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Year : 2021  |  Volume : 27  |  Issue : 5  |  Page : 37--42

End of life care in end-stage kidney disease


1 Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
2 Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
3 Department of Renal Replacement Therapy and Dialysis Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
4 MGM Health Care, Chennai, Tamil Nadu, India

Correspondence Address:
Ravindra Attur Prabhu
Department of Nephrology, Kasturba Medical College Manipal, Manipal Academy of Higher Education Manipal, Udupi, Karnataka – 576 104
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpc.ijpc_64_21

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There is a rise in burden of end-stage renal disease globally and in India. The symptom burden, prognosis, and mortality in chronic kidney disease closely mimics that of cancer. However, the palliative and end of life care needs of these patients are seldom addressed. A consensus opinion statement was developed outlining the provision of end of life care in end-stage kidney disease. Recognition of medical futility, consensus on medical futility, and cessation of potentially inappropriate therapies and medications are the initial steps in providing end of life care. Conducting a family meeting, communicating prognosis, discussing various treatment modalities, negotiating goals of care, shared decision-making, and discussion and documentation of life sustaining treatment are essential aspects of end of life care provision. The provision of end of life care entails assessment and the management of end-stage kidney disease symptoms and the care extends beyond the death of the patient to their families in the bereavement period.






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