Palliative Care for Nephrology Patients in the Intensive Care Unit

Abstract

Both nephrologists and palliative care specialists are frequently consulted on patients admitted to the intensive care unit suffering from both acute kidney injury and end-stage kidney disease. Dialysis continues to be the predominant treatment recommendation for kidney failure despite the aging population and increased incidence of comorbid conditions. Research shows patients request prognostic information and dialysis survival rates before initiating treatment; however, many patients initiate dialysis naive of their increased morbidity and mortality. Palliative care, in collaboration with nephrology, can help improve communication and a focus on shared decision making.

Keywords: Acute kidney injury; Advance care planning; Conservative care; Goals of care; Kidney failure; Palliative care; Palliative nephrology; Supportive care.