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Adv Chronic Kidney Dis. 2014 Jan;21(1):72-80. doi: 10.1053/j.ackd.2013.07.005.

Decision-making in patients with cancer and kidney disease.

Author information

1
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Geriatrics and Palliative Medicine and Renal Division, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Renal Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY. Electronic address: jennifer.scherer@mssm.edu.
2
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Geriatrics and Palliative Medicine and Renal Division, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Renal Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.

Abstract

Thoughtful decision-making in a patient with cancer and kidney disease requires a comprehensive discussion of prognosis and therapy options for both conditions framed by the individual's preferences and goals of care. An estimate of overall prognosis is generated that includes the patient's clinical presentation and parameters associated with adverse outcomes, such as age, performance status, frailty, malnutrition, and comorbidities. Empathic communication of this information using a shared decision-making approach can lead to an informed decision that respects patient autonomy and is consistent with the patient's "big-picture" goals and personal values.

KEYWORDS:

Dialysis; Onconephrology; Palliative care; Prognosis; Shared decision-making

PMID:
24359989
DOI:
10.1053/j.ackd.2013.07.005
[Indexed for MEDLINE]

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