Author(s): Farinha, Ana ; Cunha, Teresa ; Figueiredo, Cátia ; Mendes, Filipa ; Fernandes, Sara ; Sorbo, Giovanni ; Branco, Ana ; Marques da Costa, Bernardo ; Freitas, Mariana ; Mateus, Ana
Date: 2024
Origin: Portuguese Kidney Journal (PKJ)
Subject(s): Conservative Treatment; Kidney Failure; Chronic/therapy
Introduction: Elderly patients with chronic kidney disease (CKD) present a higher risk of becoming frail, a consequence of several comorbidities and worse functional status. This condition does not necessarily improve with the initiation of dialysis. Conservative care offers an option to treat elderly and/or frail patients with advanced CKD, which focuses on improving the patient’s quality of life, active symptom management and shared decision making. Conservative care has been recognized as an option for CKD patients in Portugal since 2011. Although it has been 12 years since “Norma 17” was published, not all Nephrology departments in Portugal offer this option. Methods: The Conservative Care Working Group of the Portuguese Society of Nephrology is working on identifying barriers to its implementation and possible solutions. A questionnaire was sent to all nephrology departments (n=26). Results: The answers (n=15) were discussed at a meeting. The most common barriers were insufficient knowledge in palliative care and a lack of regulation and/or reimbursement. Conclusion: Solutions for these barriers were discussed and are here reported.
