Conservative kidney management and kidney supportive care: core components of integrated care for people with kidney failure.

Claire A Douglas, Frank P Brennan, Carlos Zúñiga, Nicola Wearne, Nandini Vallath, Kaichiro Tamba, Aoife C Lowney, Kelly C Li, Rene Krause, Sahar H Koubar, Rümeyza T Kazancıoğlu, Sumiko Homma, Barnaby D Hole, Irmingarda P Gueco, Yoichi Ohtake, Brendan Smyth, Gregorio T Obrador, Harumi Kitamura, Jane O Schell, Mark A Brown, Wolfgang Pommer, Shankar P Nagaraju, Sara N Davison, Abdou Niang, Samantha L Gelfand, Jennifer S Scherer, Elena Zakharova

Journal: Kidney international 2024;105(1):35-45

PMID: 38182300

Free Full Text on Elsevier Science View on PubMed

Abstract

Integrated kidney care requires synergistic linkage between preventative care for people at risk for chronic kidney disease and health services providing care for people with kidney disease, ensuring holistic and coordinated care as people transition between acute and chronic kidney disease and the 3 modalities of kidney failure management: conservative kidney management, transplantation, and dialysis. People with kidney failure have many supportive care needs throughout their illness, regardless of treatment modality. Kidney supportive care is therefore a vital part of this integrated framework, but is nonexistent, poorly developed, and/or poorly integrated with kidney care in many settings, especially in low- and middle-income countries. To address this, the International Society of Nephrology has (i) coordinated the development of consensus definitions of conservative kidney management and kidney supportive care to promote international understanding and awareness of these active treatments; and (ii) identified key considerations for the development and expansion of conservative kidney management and kidney supportive care programs, especially in low resource settings, where access to kidney replacement therapy is restricted or not available. This article presents the definitions for conservative kidney management and kidney supportive care; describes their core components with some illustrative examples to highlight key points; and describes some of the additional considerations for delivering conservative kidney management and kidney supportive care in low resource settings.

Address: Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. Electronic address: [email protected].; Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany; Kuratorium für Dialyse und Nierentransplantation, Neu-Isenburg, Germany.; Department of Renal Medicine, St George Hospital, Kogarah, Australia; School of Clinical Medicine, University of New South Wales, Kogarah, Australia.; Department of Renal Medicine, Ninewells Hospital, Dundee, Scotland, UK.; Division of Renal (Kidney) Medicine, Department of Psychosocial Oncology and Palliative Care, Brigham and Women's Hospital, Boston, Massachusetts, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.; Section of Nephrology, The Medical City, Pasig City, National Capital Region, Philippines.; Department of Population Health, University of Bristol, Bristol, UK.; Department of Nephrology, Koga Red Cross Hospital, Koga, Ibaraki, Japan.; Division of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Türkiye.; Department of Clinical Quality Management, Osaka University Hospital, Osaka, Japan.; Division of Nephrology and Hypertension, Department of Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Division of Interdisciplinary Palliative Care and Medicine, Department of Family Community and Emergency Care, University of Cape Town, Cape Town, South Africa.; Department of Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland; Department of Palliative Medicine, Cork University Hospital, Cork, Ireland; Department of Palliative Medicine, University College Cork, Cork, Ireland.; Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.; Nephrology Department, Cheikh Anta Diop University, Dakar, Senegal.; Department of Biostatistics and Public Health, Universidad Panamericana School of Medicine, Mexico City, Mexico.; Body Mind Clinic, Takeo Clinic, Osaka, Japan.; Section of Palliative Care and Medical Ethics, Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.; Department of Internal Medicine, NYU Grossman School of Medicine, New York, New York, USA.; Department of Renal Medicine, St George Hospital, Kogarah, Australia; School of Clinical Medicine, University of New South Wales, Kogarah, Australia; National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Camperdown, Australia.; Division of Palliative Care Medicine, Juchi Medical School University Hospital, Tochigi, Japan.; Department of Palliative Medicine, St Johns National Academy of Health Sciences, Bengaluru, India.; Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.; Department of Nephrology, Botkin Hospital, Moscow, Russia.; Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile.; Kuratorium für Dialyse und Nierentransplantation, Neu-Isenburg, Germany; Department of Renal Medicine, St George Hospital, Kogarah, Australia.

DOI: 10.1016/j.kint.2023.10.001

Link outs

Free resources

Full Text Sources:

https://linkinghub.elsevier.com/retrieve/pii/S0085...

Medical:

https://medlineplus.gov/chronickidneydisease.html

MeSH Terms: Humans, Kidney, Renal Insufficiency, Renal Insufficiency, Chronic, Conservative Treatment, Delivery of Health Care, Integrated