Abstract
Kidney supportive care is central to the provision of quality patient-centered care for patients with advanced chronic kidney disease (CKD). Kidney supportive care can be defined as services aimed at improving the quality of life for patients with established CKD, at any age, throughout the continuum of illness, regardless of life expectancy and can be provided together with therapies intended to prolong life, such as dialysis. Kidney supportive care integrates culturally sensitive shared decision making to (1) prioritize the components of medical care most important to the patient and (2) ensure those priorities guide clinical decisions. Key components of kidney supportive care include relief of suffering through meticulous symptom assessment and management; emotional, social, and spiritual support; patient-specific estimates of prognosis; advance care planning; and the consideration of treatment options, such as conservative kidney management—that is, nondialysis care—and the appropriate and timely withdrawal of dialysis. This chapter discusses each of these critical components.
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