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What is Palliative and End-of-Life Care

Kidney Disease

Who is it for?

Kidneys remove waste from the body. This helps keep a balance of electrolytes (e.g., sodium and potassium) and fluids to keep people healthy. There are many causes of serious kidney (renal) disease, such as:

  • diabetes
  • high blood pressure
  • autoimmune diseases

What can kidney disease cause?

Kidneys that don’t work properly can cause:

  • problems thinking and understanding (cognition)
  • leg and body swelling
  • high blood pressure
  • itchy skin
  • pain
  • loss of appetite
  • problems sleeping, feeling very tired

What’s dialysis?

Even with treatment from kidney specialists (nephrologists), kidney disease can get worse. A person may need dialysis—a treatment that takes over the kidneys’ job. Patients discuss dialysis with their kidney specialist and some choose to manage their kidney disease without dialysis. Others who choose dialysis need to make a lot of lifestyle changes. Palliative care can help both these groups make important treatment decisions and provide emotional support.

What if a person decides to stop dialysis?

Most people reach a time when dialysis is no longer helping them. They may decide to stop dialysis, and that’s when palliative care can help to:

  • answer questions
  • manage symptoms
  • give emotional support, including supporting loved ones to deal with loss
  • helping to plan for the end-of-life
  • find other supports if people need to transition (e.g., go from home to hospital) for care

What about kidney transplants?

A kidney transplant is surgery where the diseased kidney is removed and a healthy donor kidney is put into the body. It may be an option for some people with kidney disease. These people are cared for by the transplant team, a kidney specialist, and family doctor.

How can palliative care help people waiting for a kidney transplant?

For people on a transplant list, palliative care can:

  • answer questions about symptoms and the future
  • work with transplant teams to manage symptoms while waiting for the transplant (e.g., medicine, massage, acupuncture, mindfulness, psychological and spiritual supports)
  • give emotional support and help manage symptoms before and after transplant

Not everyone on a transplant list will have the surgery. For these people and their families, palliative care can:

  • help them have a good quality of life
  • give emotional support, and comfort manage symptoms, including decreased appetite and poor sleep
  • find other supports if people need to transition (e.g., go from home to hospital) for care