Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care.
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.
Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Sara N
SN
Davison
University of British Columbia, Vancouver, British Columbia, Canada.
Adeera
A
Levin
Department of Medicine, West Virginia University, Morgantown, West Virginia, USA.
Alvin H
AH
Moss
Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.|George Institute for Global Health, New Delhi, India.
Vivekanand
V
Jha
Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
Edwina A
EA
Brown
Department of Palliative Care, St George Hospital, Sydney, New South Wales, Australia.
Frank
F
Brennan
King's College London, Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, London, UK.
Fliss E M
FE
Murtagh
Division of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Saraladevi
S
Naicker
Division of Nephrology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA.
Michael J
MJ
Germain
Renal Unit, Salford Royal NHS Foundation Trust, Salford, UK.
Donal J
DJ
O'Donoghue
School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.|Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Rachael L
RL
Morton
Universidad Panamericana School of Medicine, Mexico City, Mexico.
Gregorio T
GT
Obrador
D032921:Consensus; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D009398:Nephrology / Q000191:economics / Q000592:standards*; D058996:Quality Improvement / Q000191:economics / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000191:economics / Q000592:standards*; D006435:Renal Dialysis / Q000191:economics / Q000592:standards*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome