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Author Topic: Maximum conservative management for patients with chronic kidney disease stage 5  (Read 2461 times)
natnnnat
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« on: October 07, 2010, 09:56:33 PM »

From   http://onlinelibrary.wiley.com/doi/10.1111/j.1542-4758.2010.00488.x/abstract

BURNS, A. and DAVENPORT, A. (2010), Maximum conservative management for patients with chronic kidney disease stage 5. Hemodialysis International, 14: S32–S37. doi: 10.1111/j.1542-4758.2010.00488.x

Abstract
Following the expansion of dialysis services for patients with chronic kidney disease, an increasing number of elderly patients with varying degrees of frailty and additional comorbidities have been offered treatment. Life expectancy is somewhat limited in this group of patients, and initiation of dialysis may not necessarily improve quality of life. As such, an increasing number of centers are offering conservative care for patients who have made an informed decision not to have dialysis. As conservative care includes active treatment of anemia, volume overload, blood pressure control, and management of uremic symptoms, including pruritus, we term this approach as maximal conservative management of chronic kidney disease. We describe our experience of maximum conservative management, which although may not prolong life, can maintain the quality of life and functional ability until the final illness in the majority of patients. Although these patients do not go to the hospital on a regular basis, coordinated support from the hospital, the community, and the care giver/relative is required for successful care of the patient. Appropriate end of life planning can then be made according to the wishes of the patient.
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Natalya – Sydney, Australia
wife of Gregory, who is the kidney patient: 
1986: kidney failure at 19 years old, cause unknown
PD for a year, in-centre haemo for 4 years
Transplant 1 lasted 21 years (Lucy: 1991 - 2012), failed due to Transplant glomerulopathy
5 weeks Haemo 2012
Transplant 2 (Maggie) installed Feb 13, 2013, returned to work June 17, 2013 average crea was 130, now is 140.
Infections in June / July, hospital 1-4 Aug for infections.

Over the years:  skin cancer; thyroidectomy, pneumonia; CMV; BK; 14 surgeries
Generally glossy and happy.

2009 - 2013 PhD research student : How people make sense of renal failure in online discussion boards
Submitted February 2013 :: Graduated Sep 2013.   http://godbold.name/experiencingdialysis/
Heartfelt thanks to IHD, KK and ADB for your generosity and support.
okarol
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« Reply #1 on: October 08, 2010, 12:05:39 AM »

In some countries elderly patients are not eligible to receive dialysis treatments.
They are offered hospice instead.
Sounds like the same is being recommended here.
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
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