The use of palliative care services amongst end-stage kidney disease patients in an Irish tertiary referral centre

Hdl Handle:
http://hdl.handle.net/10147/325523
Title:
The use of palliative care services amongst end-stage kidney disease patients in an Irish tertiary referral centre
Authors:
Higgins S
Affiliation:
Our Lady's Hospice & Care Services
Citation:
Higgins S et al. The use of palliative care services amongst end-stage kidney disease patients in an Irish tertiary referral centre. Clin Kidney J. 2013 6(6):604
Publisher:
European Renal Association - European Dialysis Transplant Association
Journal:
Clinical Kidney Journal
Issue Date:
2013
URI:
http://hdl.handle.net/10147/325523
DOI:
10.1093/ckj/sft117
Additional Links:
http://ckj.oxfordjournals.org/cgi/doi/10.1093/ckj/sft117
Item Type:
Article
Language:
en
Description:
Although patients with end-stage kidney disease (ESKD) have a shortened life expectancy, their end-of-life (EOL) care is suboptimal. The aim of this study was to review the utilization of specialist palliative care (SPC) in patients with ESKD in Dublin, Ireland. We conducted a retrospective chart review of prevalent patients with ESKD who died between January 2005 and December 2009 at a tertiary referral centre. We recorded SPC referrals, modality of renal replacement therapy, age and place of death. Of 131 included patients, 88 (67.2%) were male, mean age at death was 63.2 ± 15.1 years and 102 (77.9%) were treated with haemodialysis. Forty-eight patients (36.7%) were referred to SPC, who were involved in the patients' management for a median of 12 days (range 0–907) before death. A total 104 patients (79.4%) died in an acute hospital, 19 (14.5%) died at home, 3 (2.3%) died in an inpatient hospice and the place of death was unknown for 5 patients (3.8%). Dialysis was withdrawn prior to death in 50 patients (38.1%), with a median time to death after withdrawal of dialysis of 6 days (0–105 days). A discussion regarding the withdrawal of dialysis was more frequently held with family member(s) rather than the patient. Conclusions SPC was involved in the antemortem care of ∼1/3 of the patients with the majority of referrals placed at a late stage. Given the short timeframe until death once dialysis is withdrawn, it is imperative that appropriate EOL care is instituted. This study identifies an underutilization of SPC and improved integration of palliative care and nephrology services may optimize EOL care for patients with ESKD.
Keywords:
PALLIATIVE CARE; KIDNEY DISEASE
Local subject classification:
DIALYSIS; END-OF-LIFE CARE
ISSN:
2048-8505; 2048-8513

Full metadata record

DC FieldValue Language
dc.contributor.authorHiggins Sen_GB
dc.date.accessioned2014-08-28T09:45:33Z-
dc.date.available2014-08-28T09:45:33Z-
dc.date.issued2013-
dc.identifier.citationHiggins S et al. The use of palliative care services amongst end-stage kidney disease patients in an Irish tertiary referral centre. Clin Kidney J. 2013 6(6):604en_GB
dc.identifier.issn2048-8505-
dc.identifier.issn2048-8513-
dc.identifier.doi10.1093/ckj/sft117-
dc.identifier.urihttp://hdl.handle.net/10147/325523-
dc.descriptionAlthough patients with end-stage kidney disease (ESKD) have a shortened life expectancy, their end-of-life (EOL) care is suboptimal. The aim of this study was to review the utilization of specialist palliative care (SPC) in patients with ESKD in Dublin, Ireland. We conducted a retrospective chart review of prevalent patients with ESKD who died between January 2005 and December 2009 at a tertiary referral centre. We recorded SPC referrals, modality of renal replacement therapy, age and place of death. Of 131 included patients, 88 (67.2%) were male, mean age at death was 63.2 ± 15.1 years and 102 (77.9%) were treated with haemodialysis. Forty-eight patients (36.7%) were referred to SPC, who were involved in the patients' management for a median of 12 days (range 0–907) before death. A total 104 patients (79.4%) died in an acute hospital, 19 (14.5%) died at home, 3 (2.3%) died in an inpatient hospice and the place of death was unknown for 5 patients (3.8%). Dialysis was withdrawn prior to death in 50 patients (38.1%), with a median time to death after withdrawal of dialysis of 6 days (0–105 days). A discussion regarding the withdrawal of dialysis was more frequently held with family member(s) rather than the patient. Conclusions SPC was involved in the antemortem care of ∼1/3 of the patients with the majority of referrals placed at a late stage. Given the short timeframe until death once dialysis is withdrawn, it is imperative that appropriate EOL care is instituted. This study identifies an underutilization of SPC and improved integration of palliative care and nephrology services may optimize EOL care for patients with ESKD.en_GB
dc.language.isoenen
dc.publisherEuropean Renal Association - European Dialysis Transplant Associationen_GB
dc.relation.urlhttp://ckj.oxfordjournals.org/cgi/doi/10.1093/ckj/sft117en_GB
dc.rightsArchived with thanks to Clinical Kidney Journalen_GB
dc.subjectPALLIATIVE CAREen_GB
dc.subjectKIDNEY DISEASEen_GB
dc.subject.otherDIALYSISen_GB
dc.subject.otherEND-OF-LIFE CAREen_GB
dc.titleThe use of palliative care services amongst end-stage kidney disease patients in an Irish tertiary referral centreen_GB
dc.typeArticleen
dc.contributor.departmentOur Lady's Hospice & Care Servicesen_GB
dc.identifier.journalClinical Kidney Journalen_GB
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