scholarly journals End stage kidney disease in the elderly: Hope for the best

2021 ◽  
Vol 34 (4) ◽  
Author(s):  
Patrícia Valério ◽  
◽  
Ana Farinha ◽  
Keyword(s):  
Kidney Disease ◽  
The Elderly ◽  
End Stage Kidney Disease ◽  
Disease Trajectory ◽  
Technological Advances ◽  
Care Of Elderly ◽  
End Stage ◽  
Symptomatic Control ◽  
Taking Care

With an increased number of aged chronic kidney disease (CKD) patients, along with medical and technological advances, the options to approach end‑stage kidney disease (ESKD) have multiplied. Nephrologists should be aware that taking care of elderly patients is different from taking care of younger ones. The spectrum of choices is as wide as the functional status of these patients. For fit ones, the main goal should be to restore function as much as possible and to rehabilitate. On the other hand, for frail patients, the expectations should be realistic in terms of survival, disease trajectory and symptomatic control, because while kidney replacement therapies can prolong life, they do not cure. The issue is complex due to its multidimensional perspective, so decisions must take into account the patient’s options, respecting his/her autonomy, dignity and quality of life. This text aims to review the particularities of geriatric CKD patients’ assessment towards options to care for ESKD, in a specific population which is growing in our practice.

Health-related quality of life and symptoms of conservative care versus dialysis in patients with end-stage kidney disease: a systematic review

2020 ◽  
Author(s):  
Wouter R Verberne ◽  
Iris D van den Wittenboer ◽  
Carlijn G N Voorend ◽  
Alferso C Abrahams ◽  
Marjolijn van Buren ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Older Patients ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Conservative Care ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
End Stage

Abstract Background Non-dialytic conservative care (CC) has been proposed as a viable alternative to maintenance dialysis for selected older patients to treat end-stage kidney disease (ESKD). This systematic review compares both treatment pathways on health-related quality of life (HRQoL) and symptoms, which are major outcomes for patients and clinicians when deciding on preferred treatment. Methods We searched PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus and PsycINFO from inception to 1 October 2019 for studies comparing patient-reported HRQoL outcomes or symptoms between patients who chose either CC or dialysis for ESKD. Results Eleven observational cohort studies were identified comprising 1718 patients overall. There were no randomized controlled trials. Studies were susceptible to selection bias and confounding. In most studies, patients who chose CC were older and had more comorbidities and worse functional status than patients who chose dialysis. Results were broadly consistent across studies, despite considerable clinical and methodological heterogeneity. Patient-reported physical health outcomes and symptoms appeared to be worse in patients who chose CC compared with patients who chose dialysis but had not yet started, but similar compared with patients on dialysis. Mental health outcomes were similar between patients who chose CC or dialysis, including before and after dialysis start. In patients who chose dialysis, the burden of kidney disease and impact on daily life increased after dialysis start. Conclusions The available data, while heterogeneous, suggest that in selected older patients, CC has the potential to achieve similar HRQoL and symptoms compared with a dialysis pathway. High-quality prospective studies are needed to confirm these provisional findings.

scholarly journals Quality Of Life And Health Related Quality Of Life Among End-Stage Kidney Disease Patients: Methodology Assessment

2020 ◽  
Vol 6 (3) ◽  
pp. 1-11
Author(s):  
Issa Al Salmi ◽  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Related Quality ◽  
Health Related ◽  
End Stage ◽  
The Impact

End-Stage Kidney Disease (ESKD) is a serious and irreversible condition. Understanding the impact of ESKD and its treatment on an individual's Quality of Life (QoL) is important.

scholarly journals Development of a psychosocial intervention to support informal caregivers of people with end-stage kidney disease receiving haemodialysis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Matthews ◽  
Joanne Reid ◽  
Clare McKeaveney ◽  
Robert Mullan ◽  
Stephanie Bolton ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Psychosocial Intervention ◽  
Informal Caregivers ◽  
Well Being ◽  
Care Provision ◽  
End Stage Kidney Disease ◽  
Supportive Interventions ◽  
Informal Carers ◽  
End Stage

Abstract Background Patients with end-stage kidney disease, receiving haemodialysis rely increasingly on informal carers to help manage their debilitating chronic disease. Informal carers may experience a negative impact on their quality of life exacting a toll on their physical, social and emotional well-being. Informal carers of patients with end-stage kidney disease receiving haemodialysis have significant unmet needs which may include physical and psychological issues, financial disadvantage and social isolation. Poor experiences of informal carers may also impact the experience of the patients for whom they care. The needs of this group of informal caregivers have been largely neglected, with little emphasis placed on supportive interventions that might assist and support them in their caring role. The aim of this study is therefore to explore the experiences and unmet needs of informal carers of people with end-stage kidney disease receiving haemodialysis and develop a psychosocial intervention to support them in their caring role. Methods This qualitative study will include a systematic review, semi-structured interviews with 30 informal carers and focus groups with renal health care professionals. Perceptions of care provision, caregiving experiences as well as contextual factors impacting the design and delivery of a psychosocial intervention for informal carers of patients with end-stage kidney disease, will be explored and will inform the development of a supportive intervention. Discussion The needs of informal carers of patients with end-stage kidney disease have been neglected with little emphasis placed on supportive interventions that might assist and support this group in their care giving role. This is in contrast to other chronic disease groups such as stroke, cancer and dementia. In these conditions well developed supportive interventions have significantly improved outcomes in regard to informal caregivers’ preparedness, competence, positive emotions and psychological well-being in terms of informal care provision. Support interventions could potentially improve the quality of life of those informal carers who provide care to patients with end-stage kidney disease receiving haemodialysis.

scholarly journals Components of quality of life in hemodialysis patients from family caregivers’ perspective: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sima Sadat Hejazi ◽  
Meimanat Hosseini ◽  
Abbas Ebadi ◽  
Hamid Alavi Majd
Keyword(s):  
Quality Of Life ◽  
Content Analysis ◽  
Kidney Disease ◽  
Family Caregivers ◽  
Hemodialysis Patients ◽  
End Stage Kidney Disease ◽  
The Family ◽  
End Stage ◽  
The Impact

Abstract Background Patients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients’ quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients’ disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers’ perspective. Methods In this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas’ method. Results A total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs). Conclusion Family caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients’ quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients’ quality of life and even reduce the caregivers’ burden.

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