title: Renal supportive care and palliative care: revision and proposal in kidney replacement therapy.
abstract: Patients with chronic kidney disease may receive sustained renal supportive care and renal palliative care (RPC) starting with the diagnosis of the disease, throughout the various stages of renal replacement therapy (RRT), the cessation of the RRT, and in the decision of whether to provide conservative treatment or non-initiation of RRT. This article reviews the literature on the development of renal palliative care and proposed RPC models. We describe the progression of disease in organ failure, which is very different from other areas of palliative care (PC). We describe important components of resident nephrology training in PC. We discuss the management of pain and symptom control, as well as communication skills and other psychological and ethical aspects in the renal patient. We conclude that in chronic renal patients, a palliative care approach can provide a positive impact on the quality of life of patients and their families, as well as optimizing the complex treatment of the renal patient.
authors.affiliation: Cuidados Paliativos-MIR MFyC, Hospital General de Segovia, Spain. eliopabav@gmail.com
authors.forename: Juan P
authors.initials: JP
authors.lastname: Leiva-Santos
authors.forename: Rosa
authors.initials: R
authors.lastname: Sánchez-Hernández
authors.forename: Helena
authors.initials: H
authors.lastname: García-Llana
authors.forename: M José
authors.initials: MJ
authors.lastname: Fernández-Reyes
authors.forename: Manuel
authors.initials: M
authors.lastname: Heras-Benito
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Molina-Ordas
authors.forename: Astrid
authors.initials: A
authors.lastname: Rodríguez
authors.forename: Fernando
authors.initials: F
authors.lastname: Álvarez-Ude
mesh_terms: D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D059408:Pain Management; D010166:Palliative Care; D017582:Renal Replacement Therapy / Q000941:ethics