Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
University of British Columbia, Vancouver, British Columbia, Canada.
Kidney Int. 2015 Sep;88(3):447-59. doi: 10.1038/ki.2015.110. Epub 2015 Apr 29.
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.
患有晚期慢性肾脏病 (CKD) 的患者身体和心理社会症状负担沉重,预后较差,治疗费用高昂。目前,针对这一高度脆弱人群的护理模式存在差异,预后和评估工具有限,护理质量,特别是关于保守和姑息治疗的护理质量也不尽如人意。KDIGO 慢性肾脏病支持性护理争议会议审查了当前的知识状况,以便制定路线图,指导旨在改善包括透析患者在内的晚期 CKD 患者的治疗结果的临床和研究活动。一组国际多学科专家在 CKD、姑息治疗、方法学、经济学和教育方面确定了与该人群姑息治疗相关的关键问题。会议制定了一项工作计划,以解决这一领域的突出问题,本执行摘要旨在作为指导未来工作的输出,包括制定全球适用的指南。