Supportive Care in Chronic Kidney Disease: Is it an Option?

Abstract

Supportive care in patients with chronic kidney disease refers to the application of palliative medicine principles and practices in nephrology. The main purpose is to reduce suffering by managing symptoms, helping with decision making and providing holistic support to the patient and family/caregiver in clinical, social, spiritual or nutritional distress, with a multidisciplinary team. We present the case of a 92-year-old male patient with chronic kidney disease of unknown etiology since 2004. In 2019, he was referred to our kidney disease supportive care program, presenting a serum creatinine of 5.44 mg/dL (estimated glomerular filtration rate of 9 mL/ min/1.73 m2). During the following three years, the patient lived at home independently, maintained good control of his chronic kidney diseaseassociated symptoms and preserved his functional status. We present this case as a practical example of how to approach an autonomous elderly, chronic kidney disease patient, with few comorbidities, who opted for supportive care.

Keywords

• decision making; frail elderly
• kidney failure
• chronic/therapy
• palliative care
• quality of life
• renal insufficiency