Cover Kidney News
Volume/Issue:
Volume 9: Issue 9
Page:
15
Publication Date:
01 Sep 2017
Online Publication Date:
06 Sep 2017
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    Bristowe K, et al.. The development and piloting of the Renal specific Advanced Communication Training (REACT) programme to improve Advance Care Planning for renal patients. Palliat Med 2014; 29:360–366.

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    Eneanya ND, et al.. Shared decision-making in end-stage renal disease: a protocol for a multi-center study of a communication intervention to improve end-of-life care for dialysis patients. BMC Palliat Care 2015; 14:30.

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    Ferrell BR, et al.. Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2017; 35:96–112.

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    Temel JS, et al.. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010; 363:733–742.

Editorial Type:
Special Section

Palliative Care and Nephrology: Moving Upstream Together

Daniel Lam1
  • 1 Daniel Lam, MD, is Clinical Assistant Professor of Medicine, University of Washington Department of Medicine, Division of Nephrology, and Palliative Care Medical Advisor at Northwest Kidney Centers, Harborview Medical Center, in Seattle, WA
Volume/Issue:
Volume 9: Issue 9
Publication Date:
01 Sep 2017
Page:
15
Restricted access

Patients with ESRD experience a high degree of symptom burden—physical symptom burden akin to patients with advanced cancer, along with emotional and spiritual suffering. In addition, ESRD patients on maintenance dialysis have the highest levels of medicalization at the end of life, surpassing what is experienced by their counterparts with other advanced chronic illnesses (1). Although high-intensity health care at the end of life may be goal concordant for a minority of patients, it is not on a population level. A large Veterans Affairs study evaluated family-reported quality of end-of-life care among 57,753 decedents and noted that quality
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