Abstract

The Journal of the Ceylon College of Physicians (JCCP) is a peer-reviewed, open access journal published bi-annually by the Ceylon College of Physicians (CCP) in the last week of June and December.The objective of the Journal is to promote good clinical practice and influence policy making across the medical world through publication of original research and peer reviewed articles on current issues and to foster responsible and balanced debate on issues that affect medicine and health care in Sri Lanka. Contributions to the JCCP reflect its national and multidisciplinary readership and include current thinking across a range of medical specialties.

Highlights

  • Global prevalence of chronic kidney disease (CKD) is on the rise

  • Selecting the appropriate patient with advanced CKD for the suitable renal replacement therapy (RRT), identifying patients who will not benefit from RRT and integrating palliative care principles to the routine management of advanced CKD has become a global necessity

  • Renal supportive care is the service provision aimed at raising the health-related quality of life (QOL) of a patient diagnosed with CKD

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Summary

Chronic kidney disease burden

Global prevalence of chronic kidney disease (CKD) is on the rise. Further to the increase in its prevalence, patients with advanced CKD depict an enormous burden of physical and psychosocial symptoms, poor outcomes, and huge costs of care. The life expectancy on dialysis is poor and the advanced disability and symptom burden in some patients with advanced CKD is not essentially improved by dialysis therapies. Due to the mammoth cost involved with different renal replacement therapies, it is a huge economic burden for the country as well. Selecting the appropriate patient with advanced CKD for the suitable renal replacement therapy (RRT), identifying patients who will not benefit from RRT and integrating palliative care principles to the routine management of advanced CKD has become a global necessity. This article will illustrate the essential components of renal supportive care, a treatment modality developed to solve these issues

What is supportive care?
What is renal supportive care?
Effective Communication Shared decision making Advanced Care Planning
Initial considerations for management
Sleep disorders
Manage associated reversible symptoms such as constipation
Depressive symptoms
Shared decision making
Advanced Care Planning
Comprehensive Conservative Care
Withdrawal from dialysis
Palliative dialysis
Who should provide renal supportive care?
Findings
Conclusion
Full Text
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