대한신장학회

Skip Navigation: Skip to contents

KOR
ENG
전체메뉴보기

간행물 검색

현재 페이지 경로

HOME
간행물
간행물 검색

논문분류	춘계학술대회 초록집
제목	Conservative Kidney Management
저자	Sung Joon Shin
출판정보	2024; 2024(1):
키워드
초록	Conservative kidney management refers to a comprehensive approach for patients with end-stage renal failure, which encompasses not only medical treatment for kidney disease but also symptom management, advanced care planning, end-of-life care, and palliative care, without resorting to renal replacement therapies such as dialysis or transplantation. This approach represents a broader concept than merely managing uremic symptoms without dialysis. A survey conducted by the International Society of Nephrology in 2018, involving 182 countries, revealed that conservative kidney management is feasible in 124 out of 154 countries (81%). Seventy-seven countries, including South Korea, reported that despite having adequate medical resources for renal replacement therapy, conservative kidney management is offered based on patient choice or medical decision. Among these countries, 57 (37%) provide a multidisciplinary approach to conservative kidney management, 40 (26%) utilize shared decision-making tools, and psychological, cultural, and spiritual support for patients receiving conservative kidney management is available in 45 countries. The timing for discussing conservative kidney management should be individualized based on the patient's condition and the degree of renal function decline. Typically, this discussion coincides with the time when dialysis education becomes necessary, often when the estimated glomerular filtration rate falls to 20-30 ml/min/1.73 m2, although this is not a strict rule. However, it is crucial to ensure that patients and their caregivers do not perceive conservative kidney management as medical neglect or abandonment. Given its association with withholding or discontinuing dialysis treatment, an ethical approach is paramount. Conservative kidney management must be tailored to each patient's situation, symptoms, and personal characteristics through shared decision-making. As patients' preferences, values, goals, and medical conditions may change over time, the objectives of conservative kidney management should be reevaluated and adjusted as necessary.
원문(PDF)	PDF 원문보기

목록

위로가기