期刊
SEMINARS IN NEPHROLOGY
卷 37, 期 2, 页码 173-180出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.semnephrol.2016.12.007
关键词
Advance care planning; chronic kidney disease; shared decision making; palliative care; conservative care
Patients with chronic kidney disease typically suffer a cascade of comorbid conditions, the magnitude of which have formidable impact on advance care planning (ACP). Complex health care decisions are complicated further by contextual issues that may change over time. A dynamic and evolving process, ACP ideally begins early in the continuum of chronic kidney disease, long before end-stage kidney disease is reached. Planning ahead for care is preparatory to making decisions about kidney replacement therapy and can make for a smooth transition in addition to preventing the start of dialysis by default. This article addresses the key components and unique aspects of ACP for patients approaching dialysis, highlighting the importance of shared decision making, and its effect on the execution of multiple aspects of transition. (C) 2017 Elsevier Inc. All rights reserved.
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