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When to Consider Hospice for Kidney Disease

Importance of Hospice Care for Kidney Failure

Navigating the complexities of end-stage kidney disease, also known as end-stage renal disease (ESRD), can be daunting for patients and their families. As kidney failure progresses, it often elevates challenges, including managing symptoms, maintaining quality of life, and making difficult decisions about hospice care options. In this article, we explore when to consider hospice and how it can provide compassionate care and support during an overwhelming time.

When to Consider Hospice Care for Kidney Disease?

Several factors may indicate that it’s time to consider hospice care for individuals with kidney failure:

Decline in Kidney Function

As kidney function continues to deteriorate despite medical interventions, hospice can provide specialized support tailored to the individual’s needs, such as enforcing a restricted diet.

Persistent Kidney Failure Symptoms

If symptoms such as pain, fatigue, nausea, or difficulty breathing become increasingly challenging to manage, hospice can offer expert symptom management to improve comfort for individuals with chronic kidney disease.

Desire to Focus on Comfort

When curative treatments, such as dialysis, are no longer effective or desired, hospice shifts the focus to providing comfort and improving quality of life for the remainder of the patient’s life.

Caregiver Burnout

When caregiving responsibilities become overwhelming for family members or caregivers, hospice can provide support and relief, ensuring both the patient and their caregivers receive the assistance they need.

Hospice Benefit Qualifiers for Kidney Disease

  • Creatinine clearance of <10cc/min (<15cc/min for diabetics) AND serum creatinine >8.0 mg/dl (>6.0 mg/dl for diabetics) or GFR of less than 10
  • Patient has chosen not to have renal dialysis
  • Structural and functional impairments
  • Comorbid and secondary conditions contribute to terminal prognosis
  • Nausea or vomiting
  • Uremia with obtundation
  • Intractable hyperkalemia
  • Hepatorenal syndrome
  • Platelet count <25,000
  • Pruritus
  • Self-care deficits
  • Activity limitations
  • Uremic pericarditis
  • Anorexia
  • Albumin <3.5 gm/dl

Purpose of Hospice Care for Kidney Disease

Hospice care provides comprehensive support and comfort during the advanced stages of kidney disease. Hospice focuses on enhancing the quality of life by managing symptoms such as pain, nausea, and fatigue, while also addressing the emotional, spiritual, and practical needs of patients and their families. Hospice care teams (consisting of healthcare professionals including nurses, social workers, and counselors) collaborate to ensure personalized care tailored to the individual’s preferences and goals. Additionally, hospice fosters open communication about end-of-life wishes and facilitates a peaceful and dignified transition for patients nearing the end of their journey with kidney disease.

Understanding End-Stage Kidney Disease

End-stage kidney disease occurs when the kidneys are no longer able to function to maintain life. This could be due to various reasons, such as chronic conditions including diabetes or high blood pressure, or other kidney-related illnesses. As kidney failure progresses, individuals may experience a decline in kidney function, leading to complications such as fluid retention, electrolyte imbalances, and toxin buildup. According to the National Center for Biotechnology Information, more than 500,000 people in the United States live with end-stage renal disease.

In conclusion, considering hospice care for individuals with kidney disease is an important decision that should be based on the individual’s medical condition, symptom management needs, and personal preferences. By offering comprehensive support and focusing on improving quality of life, hospice can provide comfort and dignity to patients and their families during this challenging journey of end-stage kidney failure.