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Review
. 2021 Dec 2;4(2):100392.
doi: 10.1016/j.xkme.2021.10.005. eCollection 2022 Feb.

Kidney Supportive Care in Peritoneal Dialysis: Developing a Person-Centered Kidney Disease Care Plan

Emily Lu  1   2 , Emily Chai  1   2
Affiliations
Review

Kidney Supportive Care in Peritoneal Dialysis: Developing a Person-Centered Kidney Disease Care Plan

Emily Lu et al. Kidney Med. .

Abstract

Individuals receiving peritoneal dialysis (PD)-similar to those receiving hemodialysis -may experience high mortality coupled with a high symptom burden and reduced health-related quality of life. In this context, a discussion of the risks, benefits, and tradeoffs of PD and/or other kidney treatment modalities should be explored based on individual goals and preferences. Through these principles, kidney supportive care provides a person-centered approach to kidney disease care throughout the spectrum of kidney failure and earlier stages of chronic kidney disease. Kidney supportive care is offered in conjunction with life-prolonging therapies, including dialysis and kidney transplants, and is increasingly recognized as an integral part of advancing the care of PD patients. Using "My Kidney Care Roadmap" for shared decision making, kidney supportive care guides patients undergoing PD and their clinicians to (1) elicit patient goals, values, and priorities; (2) convey medical prognosis and suitable treatment options; and (3) ask "Which of these kidney treatment options will best help me achieve my goals and priorities?" to inform both current and future decisions, including choice of dialysis modalities, time-limited trials, and/or nondialysis management. Recognizing that patient priorities and choices may evolve, this framework ultimately allows patients to continually reassess their PD care to better achieve goal-directed dialysis.

Keywords: Advance care planning; chronic kidney disease; dialysis; end-stage kidney disease; end-stage renal disease; kidney failure; kidney supportive care; palliative care; peritoneal dialysis; renal failure; renal palliative care; shared decision-making; supportive care.

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Figures

Figure 1
Figure 1
My Kidney Care Roadmap. APD, automated peritoneal dialysis; CAPD, continuous ambulatory peritoneal dialysis; HD, hemodialysis; PD, peritoneal dialysis.
Figure 2
Figure 2
Defining kidney treatment options: What is important to me? What should I ask my doctor?
Figure 3
Figure 3
Should I consider making a change in my dialysis (PD) treatment? PD, peritoneal dialysis.
See this image and copyright information in PMC

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