Supportive palliative care should be integrated into routine care for paediatric patients with life-limiting kidney disease

Acta Paediatr. 2018 Mar;107(3):403-407. doi: 10.1111/apa.14182. Epub 2017 Dec 22.

Abstract

Paediatric palliative care is no longer restricted to patients with cancer and has been extended to patients with other chronic conditions, such as cystic fibrosis or neuromuscular disorders. This review focused on the current state of palliative care for children and adolescents with chronic kidney disease (CKD). We assessed the literature on CKD published up to August 2017. All the papers, except one from 1996, were published this century. This review discusses the role that palliative care plays in the process of decision-making and explores the possibilities of implementing palliative care into the routine therapy of affected patients and providing support for their families. Offering early palliative care as an integral part of the kidney, supportive care provided by the nephrology care team is both necessary and feasible for patients with CKD. As a minimum, a specialised palliative care team should be involved in patients with multiple comorbidities, in conservative treatment scenarios and in acute life-threatening complications. Further studies and guidelines are required to improve the care of patients with CKD and their families.

Conclusion: Supportive palliative care should be implemented into the routine care of patients with life-limiting kidney disease.

Keywords: Chronic kidney disease; Dialysis; End-stage renal disease; Kidney supportive care; Paediatric palliative care.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Clinical Decision-Making
  • Female
  • Humans
  • Life Expectancy*
  • Male
  • Palliative Care / organization & administration*
  • Pediatrics / methods
  • Program Development
  • Program Evaluation
  • Quality of Life
  • Renal Dialysis / methods*
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / mortality
  • Renal Insufficiency, Chronic / therapy*
  • Severity of Illness Index
  • Survival Analysis