Chronic kidney disease continuous care (Supportive and conservative treatment)

Abstract

The quality of life of patients with chronic kidney disease (CKD) and their families is negatively affected, with or without replacement therapies (dialysis or transplantation). The high burden of physical symptoms and psychosocial changes is associated with disease progression, with higher overload in the end-stage renal disease (ESRD). The physical and emotional symptoms are of high prevalence, and the number and intensity of symptoms is comparable to that reported by patients with cancer or AIDS. The current model of attention focused on the disease and treatment, through dialysis or renal transplant, improves biomedical parameters and greater survival, but does not necessarily improve the quality of life of patients, because it does not address or integrate important psychosocial, ethical, affective, and emotional and spiritual aspects that affect patients with ESRD. The integration of a model based on the principles of palliative medicine, focused on the sick person and their quality of life, would allow to address in a comprehensive and timely manner several of these problems typical of patients with CKD and complement the deficiencies of the traditional biomedical model. In this regard, there is sufficient information that validates the implementation of palliative care in dialysis, and already several societies and scientific organizations of nephrology worldwide have begun to promote the integration of support/palliative care in nephrology/dialysis units, as well as its inclusion in pre- and post-degree training programs for professionals in the specialty.