Advance Care Planning in End‐Stage Renal Disease
DOI:
https://doi.org/10.71749/pkj.41Keywords:
Advance Care Planning, Advance Directives, Kidney Failure, ChronicAbstract
Patients with end‐stage renal disease (ESRD) have high morbidity and mortality rates compared to age‐matched individuals. The treatment for ESRD typically involves renal replacement therapies such as dialysis or kidney transplant. Despite the high comorbidity and frailty presented by the patients with ESRD, many of these individuals do not discuss their end‐of‐life preferences with loved ones or healthcare providers, leading to difficult decisions for surrogates. Advance care planning (ACP) emerges as a valuable strategy to facilitate collaborative decision‐making about future healthcare, yet its application remains low. In Portugal, while laws exist to support ACP through living will (LW), their prevalence is notably low. Training healthcare professionals in ACP is essential to ensure effective communication and support for patients and families. Organizational support, such as policy endorsement and adequate staffing levels, is crucial for successful ACP implementation. It is imperative to encourage patients with ESRD to discuss their preferences regarding future healthcare, including dialysis management at the end‐of‐life.Downloads
References
Davison SN, Jhangri GS, Johnson JA. Cross‐sectional validity of a modified Edmonton symptom assessment system in dialysis patients: a simple assessment of symptom burden. Kidney Int. 2006;69:1621 doi:10.1038/sj.ki.5000184
Saran R, Li Y, Robinson B, Abbott KC, Agodoa LY, Ayanian J, et al. US Renal Data System 2015 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2016;67:Svii, S1‐305. doi: 10.1053/j.ajkd.2015.12.014.
United States Renal Data System. USRDS Annual Data Report. [Accessed March 2, 2024]. Available at: https://usrds‐adr.niddk.nih.gov
Verberne WR, Geers AB, Jellema WT, Vincent HH, van Delden JJ, Bos WJ. Comparative Survival among Older Adults with Advanced Kidney Disease Managed Conservatively Versus with Dialysis. Clin J Am Soc 9. Nephrol. 2016;11:633‐40. doi:10.2215/CJN.07510715
Kurella Tamura M, Yaffe K. Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies. Kidney Int. 2011;79:14‐22. doi:10.1038/ki.2010.336
Arulkumaran N, Szawarski P, Philips BJ. End‐of‐life care in patients with end‐stage renal disease. Nephrol Dial Transplant. 2012;27:879‐81. doi:10.1093/ndt/gfs028
Feely MA, Hildebrandt D, Edakkanambeth Varayil J, Mueller PS. Prevalence and Contents of Advance Directives of Patients with ESRD Receiving Dialysis. Clin J Am Soc Nephrol. 2016;11:2204 doi:10.2215/CJN.12131115
Crail S, Walker R, Brown M, Group RSC working. Renal supportive and palliative care: position statement. Nephrology. 2013;18:393‐400. doi:10.1111/nep.12064
Nephrology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal, Farinha A. Choices for life: how can we help? Port J Nephrol Hypertens. 2021;35. doi:10.32932/pjnh.2021.10.137
Brinkman‐Stoppelenburg A, Rietjens JA, van der Heide A. The effects of advance care planning on end‐of‐life care: a systematic review. Palliat Med. 2014;28:1000‐25. doi:10.1177/0269216314526272
Song MK, Ward SE, Fine JP, Hanson LC, Lin FC, Hladik GA, et al. Advance care planning and end‐of‐life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates. Am J Kidney Dis. 2015;66:813‐22. doi:10.1053/j.ajkd.2015.05.018
Schmidt RJ, Weaner BB, Long D. The power of advance care planning in promoting hospice and out‐of‐hospital death in a dialysis unit. J Palliat Med. 2015;18:62‐6. doi:10.1089/jpm.2014.0031
Morton RL, Webster AC, McGeechan K, Howard K, Murtagh FE, Gray NA, et al. Conservative Management and End‐of‐Life Care in an Australian Cohort with ESRD. Clin J Am Soc Nephrol. 2016;11:2195‐203. doi:10.2215/CJN.11861115
Weisbord SD, Carmody SS, Bruns FJ, Rotondi AJ, Cohen LM, Zeidel ML, et al. Symptom burden, quality of life, advance care planning and the potential value of palliative care in severely ill haemodialysis patients. Nephrol Dial Transplant. 2003;18:1345‐52. doi:10.1093/ ndt/gfg105
Swartz RD, Perry E. Advance directives are associated with “good deaths” in chronic dialysis patients. J Am Soc Nephrol. 1993;3:1623‐ ‐30. doi:10.1681/ASN.V391623
Kurella Tamura M, Montez‐Rath ME, Hall YN, Katz R, O’Hare AM. Advance Directives and End‐of‐Life Care among Nursing Home Residents Receiving Maintenance Dialysis. Clin J Am Soc Nephrol. 2017;12:435‐42. doi:10.2215/CJN.07510716
Fisher MC, Chen X, Crews DC, DeGroot L, Eneanya ND, Ghildayal N, et al. Advance Care Planning and Palliative Care Consultation in Kidney Transplantation. Am J Kidney Dis. 2024;83:318‐28. doi: 10.1053/j. ajkd.2023.07.018.
Wang YH, Enguidanos S. Comparing variations in advance di‐ rectives timing among older adults with end‐stage renal disease versus cancer. Am J Hosp Palliat Med. 2023;40:147‐52. doi:10.1177/10499091221097676
Lou Y, Carr D. Racial and Ethnic Disparities in Advance Care Planning: Assessing the Role of Subjective Life Expectancy. J Gerontol B Psychol Sci Soc Sci. 2022;77:1508‐18. doi:10.1093/geronb/gbac003
Gomes BMM, Salomão LA, Simões AC, Rebouças BO, Dadalto L, Bar‐ bosa MT. Diretivas antecipadas de vontade em geriatria. Rev Bioét. 2018;26:429‐39. doi:10.1590/1983‐80422018263263
O’Halloran P, Noble H, Norwood K, Maxwell P, Shields J, Fogarty D, et al. Advance Care Planning With Patients Who Have End‐Stage Kid‐ ney Disease: A Systematic Realist Review. J Pain Symptom Manage. 2018;56:795‐807.e18. doi:10.1016/j.jpainsymman.2018.07.008
Cogo S, Lunardi V, Quintana A, Girardon‐Perlini N, Silveira R. Diretivas antecipadas: desejos dos profissionais da saúde e cuidadores familiares. Rev Baiana Enferm. 2017;31. doi:10.18471/rbe.v31i1.16932
Portugal. Lei n.o 25/2012 | DR. [Accessed March 5, 2024]. Available at: https://diariodarepublica.pt/dr/detalhe/lei/25‐2012‐179517
Dadalto L, Tupinambás U, Greco DB. Diretivas antecipadas de vontade: um modelo brasileiro. Rev Bioét. 2013;21:463‐76.
NephroCare Setúbal, Setúbal, Portugal, Farinha A, Mendes B, et al. How do our Dialysis Patients Die? Port J Nephrol Hypertens. 2023;37. doi:10.32932/pjnh.2023.02.220
Instituto Nacional de Estatística. Portal do INE. [Accessed March 5, 2024]. Available at:https://www.ine.pt/
Registo de Testamentos Vitais. Accessed March 5, 2024. https://transparencia.sns.gov.pt
Yadav KN, Gabler NB, Cooney E, Kent S, Kim J, Herbst N, et al. Approximately one in three US adults completes any type of advance directive for end‐of‐life care. Health Aff. 2017;36:1244‐51. doi: 10.1377/ hlthaff.2017.0175.
Barreto AL, Capelas ML. Conhecimento dos profissionais de saúde sobre as diretivas antecipadas de vontade. Cad Saúde. 2020:36‐40. doi:10.34632/CADERNOSDESAUDE.2020.5834
Barreto ALF, Capelas ML. Atitudes dos profissionais de saúde sobre as diretivas antecipadas de vontade. Cuid Paliat. 2023;8:25‐30.
Tratamento Conservador Médico da Insuficiência Renal Crónica Estádio 5. [Accessed March 5, 2024]. Available at: https://normas.dgs.min‐saude.pt/2011/09/28/tratamento‐conservador‐medico‐da‐‐insuficiencia‐renal‐cronica‐estadio‐5/
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