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Adv Chronic Kidney Dis. 2014 Jul;21(4):385-91. doi: 10.1053/j.ackd.2014.03.012.

An interdisciplinary approach to dialysis decision-making in the CKD patient with depression.

Author information

1
Renal-Electrolyte Division, Section of Palliative Care and Medical Ethics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA; Mid-Atlantic Renal Coalition, Richmond, VA; Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: schelljo@upmc.edu.
2
Renal-Electrolyte Division, Section of Palliative Care and Medical Ethics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA; Mid-Atlantic Renal Coalition, Richmond, VA; Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Abstract

Depression and depressive symptoms are common in advanced kidney disease and are associated with poor outcomes. For those with CKD not on dialysis, depression may influence how patients cope and prepare for their disease and its management, including decisions about dialysis treatment. Patient self-reported scales exist to better identify depression; how to incorporate these scales into clinical practice and assist with treatment decision-making is less clear. We present a case-based discussion of depressive symptoms in patients with advanced kidney disease not on dialysis. We highlight the contribution of underlying somatic and psychosocial factors in the assessment and management of depression. We further define the role of the interdisciplinary care team, including palliative care and hospice medicine, to assist with symptom management and end-of-life care for CKD patients with depression.

KEYWORDS:

Chronic kidney disease; Depression; End of life; Interdisciplinary team; Palliative care

PMID:
24969392
DOI:
10.1053/j.ackd.2014.03.012
[Indexed for MEDLINE]

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