Advanced kidney disease (AKD) (eGFR <15 ml/min) is a complex illness associated with high morbidity and mortality. Palliative care (PC) emphasizes the management of symptoms along with discussions with patients and their families regarding prognosis in order to help clarify their goals in managing their illness. Despite the evidence of improved outcomes for patients with AKD receiving PC, the use of PC for patients has been limited, possibly due to limited access of patients to PC services and the lack of resources available to the renal care providers to seek appropriate PC consultation (PCC). We aimed to study patients with terminal AKD who have been followed by nephrologists in the outpatient setting and were admitted to a tertiary care hospital where resources are available for PCC to further understand the pattern of PCC (or the lack of it) of these patients and to shed light on the outcome of such consultations. We retrospectively studied 126 patients with AKD (eGFR<15 ml/min) who were previously seen by a nephrologist and who were hospitalized at University of Virginia (UVA) between 1/1/18-3/31/19 and died during that period. Difference in demographic, comorbidities, goals of care (GOC), advance directives (AD), do not resuscitate (DNR) and hospice between patients with and without PCC were compared. PCC was obtained in 72 patients (57.1%). There were no statistical differences in demographics or comorbidities between the two groups except higher % of congestive heart failure (CHF) in PCC group. Patients with PCC had significantly better outcome measures of GOC discussion, AD planning, DNR documentation, and hospice referral.Tabled 1PCC + (n=72, 57.1%)PCC – (n=54, 42.9%)P valueAge (years)66.67 +/- 14.565.1 +/- 13.2Gender (M %)54.1500.13Race (W %)56.968.50.06Hypertension (%)87.584.90.19Diabetes Mellitus (%)58.359.30.14Coronary artery disease (%)38.933.30.12CHF (%)52.817<0.0001Dialysis (%)69.470.40.15GOC (%)97.246.3<0.0001AD (%)56.937.7<0.0001DNR (%)81.741.5<0.0001Hospice (%)48.69.3<0.0001 Open table in a new tab Despite the improved care of patients with AKD noted when PC are consulted in a subset of terminally ill patients, PCC are still underutilized even when resources are available. We recommend PCC for patients with AKD in order to improve their end of life experience.