POS-672 CONSERVATIVE AND PALLIATIVE CARE OF PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE

Abstract

The number of patients with advanced chronic kidney disease who opt for supportive therapy or withdraw from dialysis is increasing world widely. In our research we verified the knowledge of legal regulations, the attitude towards conservative therapy, dialysis withdrawal and palliative care in patients with advanced chronic kidney disease in Slovenia. The research was performed among nephrologists and nephrology fellows using an electronic survey based on modified European research »European Renal Best Practice Survey«. Forty-one nephrologists and nephrology fellows of the Slovenian Society of Nephrology participated in the research, 59% were female, the majority (55%) aged 35 to 50 with more than 10 years of service (57%) in the inpatient setting (50%). 39% of the participants knew that the right to palliative care in our country has a legal background and 32% were familiar with the legal possibility of advanced patients will on intensity of treatment. According to participants opinion, 79% of their patients were not familiar with the option of advanced will although the great majority of participants were familiar with the definition of patient autonomy. 11% of participants reported withdrawal from dialysis on the request of the patient. In 86% of participants the decision on dialysis withdrawal was based on the proposition of the patient or his relatives (76%) after detailed consultation with other nephrologists. Only 48% of nephrologists would respect the patient advanced will to withdraw from dialysis if his relatives opposed. 84% of the participants believed that health professionals are not familiar enough with the organization of palliative care in their region, although 57% of their patients were discharged in their home environment. 59% of nephrologists attended education on the topic of palliative care, mostly on national meetings (88%). We need to improve the knowledge of nephrologists on supportive and palliative care in nephrology, their communication skills and knowledge on legal patients’ rights to be able to fully respect autonomy of patients, based on timely extensive education of patients considering their therapeutic options and advanced will.