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Decision-making in advanced CKD
Decision-making in advanced chronic kidney disease (CKD) is a complex process, as it involves choosing the best treatment path to manage kidney function decline. Key considerations include the patient’s medical condition, quality of life, personal values, and prognosis. Here’s an overview:
1. Treatment Options
- Dialysis:
- Hemodialysis (HD): Performed at a clinic or at home. Blood is filtered using a machine.
- Peritoneal Dialysis (PD): Uses the lining of the abdomen to filter blood. Done at home.
- Kidney Transplant: A new kidney from a donor can improve quality of life and longevity, but it requires eligibility (overall health) and availability of a donor.
- Conservative Management: For patients who do not wish to pursue dialysis or a transplant, this option focuses on symptom management, improving comfort, and maintaining quality of life without aggressive interventions.
2. Factors to Consider
- Prognosis: Age, comorbidities (e.g., heart disease, diabetes), and life expectancy with and without dialysis.
- Quality of Life: How dialysis or transplantation will impact daily activities, independence, and emotional well-being.
- Personal Preferences: Some may prioritize life extension, while others may focus on maintaining current quality of life, free from the burdens of dialysis.
- Advanced Directives: Establishing clear wishes about treatment in cases of life-threatening complications is important.
3. Shared Decision-Making
- Involves the patient, family, and healthcare providers discussing the benefits, risks, and outcomes of each option.
- Counseling and education about dialysis, transplantation, and conservative care are crucial to help patients make informed choices.
4. End-of-Life Considerations
- For those who opt for conservative care or choose to discontinue dialysis, palliative care becomes essential to manage symptoms and maintain dignity at the end of life.
5. Timing of Decision:
- Decisions are often made when kidney function (eGFR) drops below 20, and it is clear that kidney failure is imminent. Planning ahead ensures smoother transitions into whichever treatment pathway is chosen.
Would you like to dive deeper into any of these aspects?
The Migraine And Headache Program™ By Christian Goodman This program has been designed to relieve the pain in your head due to any reason including migraines efficiently and effectively. The problem of migraine and headaches is really horrible as it compels you to sit in a quiet and dark room to get quick relief. In this program more options to relieve this pain have been discussed to help people like you.