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Medline ® Abstract for Reference 60

of 'Palliative care: End-stage renal disease'

A palliative approach to dialysis care: a patient-centered transition to the end of life.
Grubbs V, Moss AH, Cohen LM, Fischer MJ, Germain MJ, Jassal SV, Perl J, Weiner DE, Mehrotra R, Dialysis Advisory Group of the American Society of Nephrology
Clin J Am Soc Nephrol. 2014;9(12):2203. Epub 2014 Aug 7.
As the importance of providing patient-centered palliative care for patients with advanced illnesses gains attention, standard dialysis delivery may be inconsistent with the goals of care for many patients with ESRD. Many dialysis patients with life expectancy of<1 year may desire a palliative approach to dialysis care, which focuses on aligning patient treatment with patients' informed preferences. This commentary elucidates what comprises a palliative approach to dialysis care and describes its potential and appropriate use. It also reviews the barriers to integrating such an approach into the current clinical paradigm of care and existing infrastructure and outlines system-level changes needed to accommodate such an approach.
Division of Nephrology, University of California, San Francisco, San Francisco, California; Division of Nephrology, San Francisco General Hospital, San Francisco, California; grubbsv@medsfgh.ucsf.edu.