title: Supportive Care: Integration of Patient-Centered Kidney Care to Manage Symptoms and Geriatric Syndromes.
abstract: Dialysis care is often associated with poor outcomes including low quality of life (QOL). To improve patient-reported outcomes, incorporation of the patient's needs and perspective into the medical care they receive is essential. This article provides a framework to help clinicians integrate symptom assessment and other measures such as QOL and frailty scores into a clinical approach to the contemporary supportive care of patients with advanced CKD. This approach involves (1) defining our understanding of kidney supportive care, patient-centered dialysis, and palliative dialysis; (2) understanding and recognizing common symptoms associated with advanced CKD; (3) discussing the concepts of physical function, frailty, and QOL and their role in CKD; and (4) identifying the structural and process barriers that may arise when patient-centered dialysis is being introduced into clinical practice.
authors: Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; and.
authors: Sara N
authors: SN
authors: Davison
authors: Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors: Sarbjit Vanita
authors: SV
authors: Jassal
mesh_terms: D000058:Accidental Falls; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D000073496:Frailty / Q000175:diagnosis; D005767:Gastrointestinal Diseases / Q000209:etiology; D015577:Geriatric Assessment; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D010146:Pain / Q000209:etiology; D010166:Palliative Care; D018802:Patient-Centered Care / Q000458:organization & administration; D011537:Pruritus / Q000209:etiology; D011788:Quality of Life; D006435:Renal Dialysis; D012893:Sleep Wake Disorders / Q000209:etiology; D063189:Symptom Assessment; D013577:Syndrome
keywords: Chronic; Disease Management; Humans; Patient Outcome Assessment; Patient-Centered Care; Renal Insufficiency; Symptom Assessment; frailty; kidney; quality of life; renal dialysis; supportive care; symptoms