title: Home Palliative Care for Patients with Advanced Chronic Kidney Disease: Preliminary Results.
abstract: Healthcare for patients with advanced chronic kidney disease (ACKD) on conservative treatment very often poses healthcare problems that are difficult to solve. At the end of 2011, we began a program based on the care and monitoring of these patients by Primary Care Teams. ACKD patients who opted for conservative treatment were offered the chance to be cared for mainly at home by the Primary Care doctor and nurse, under the coordination of the Palliative Care Unit and the Nephrology Department. During 2012, 2013, and 2014, 76 patients received treatment in this program (mean age: 81 years; mean Charlson age-comorbidity index: 10, and mean glomerular filtration rate: 12.4 mL/min/1.73 m²). The median patient follow-up time (until death or until 31 December 2014) was 165 days. During this period, 51% of patients did not have to visit the hospital's emergency department and 58% did not require hospitalization. Forty-eight of the 76 patients died after a median time of 135 days in the program; 24 (50%) died at home. Our experience indicates that with the support of the Palliative Care Unit and the Nephrology Department, ACKD patients who are not dialysis candidates may be monitored at home by Primary Care Teams.
authors.affiliation: Nephrology Department, Instituto Ram&#243;n y Cajal de Investigaci&#243;n Sanitaria (IRYCIS), Red de Investigaci&#243;n Renal (REDinREN), Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. jteruel.hrc@salud.madrid.org.
authors.forename: José L
authors.initials: JL
authors.lastname: Teruel
authors.affiliation: Hospital Palliative Care Unit, Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. lrexach@segg.es.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Rexach
authors.affiliation: Nephrology Department, Instituto Ram&#243;n y Cajal de Investigaci&#243;n Sanitaria (IRYCIS), Red de Investigaci&#243;n Renal (REDinREN), Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. victor.burguera@salud.madrid.org.
authors.forename: Victor
authors.initials: V
authors.lastname: Burguera
authors.affiliation: Nephrology Department, Instituto Ram&#243;n y Cajal de Investigaci&#243;n Sanitaria (IRYCIS), Red de Investigaci&#243;n Renal (REDinREN), Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. antonio.gomis@salud.madrid.org.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gomis
authors.affiliation: Nephrology Department, Instituto Ram&#243;n y Cajal de Investigaci&#243;n Sanitaria (IRYCIS), Red de Investigaci&#243;n Renal (REDinREN), Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain.
authors.forename: Milagros
authors.initials: M
authors.lastname: Fernandez-Lucas
authors.affiliation: Nephrology Department, Instituto Ram&#243;n y Cajal de Investigaci&#243;n Sanitaria (IRYCIS), Red de Investigaci&#243;n Renal (REDinREN), Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. maiteelizabeth.rivera@salud.madrid.org.
authors.forename: Maite
authors.initials: M
authors.lastname: Rivera
authors.affiliation: Hospital Palliative Care Unit, Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. adiaza@salud.madrid.org.
authors.forename: Alicia
authors.initials: A
authors.lastname: Diaz
authors.affiliation: Home Palliative Care Unit, Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. sergio.collazo@salud.madrid.org.
authors.forename: Sergio
authors.initials: S
authors.lastname: Collazo
authors.affiliation: Nephrology Department, Instituto Ram&#243;n y Cajal de Investigaci&#243;n Sanitaria (IRYCIS), Red de Investigaci&#243;n Renal (REDinREN), Hospital Universitario Ram&#243;n y Cajal, Carretera de Colmenar km 9100, Madrid 28034, Spain. fernando.liano@salud.madrid.org.
authors.forename: Fernando
authors.initials: F
authors.lastname: Liaño
keywords: advanced chronic kidney disease; home palliative care