Multidisciplinary approach to advance care planning and directives in patients with end-stage renal disease: a point of view on patient-centered decision-making

J Nephrol. 2024 Sep;37(7):1821-1825. doi: 10.1007/s40620-024-02002-w. Epub 2024 Jun 28.

Abstract

Implementing Advance Care Planning (ACP) for patients with End-Stage Kidney Disease (ESKD), particularly in the context of hemodialysis, presents significant challenges. Despite existing legal frameworks, disparities in advance care planning practices are evident across Europe. The present perspective introduces a multidisciplinary model, initiated in 2019. This model incorporates a specialized team comprising a nephrologist, a psychologist, a palliative care specialist, and an anesthesiologist/intensivist. Through this collaborative approach, we aimed to comprehensively address the intricate medical, emotional, and psychological dimensions in advance care planning. In this point of view, we discuss the strengths of our model, its potential for European Nephrology, and advocate for guidelines to enhance advance care planning implementation within the nephrology community.

Keywords: Advance care planning (ACP); End-stage kidney disease (ESKD); Multidisciplinary approach; Patient-centered decision-making.

Publication types

  • Review

MeSH terms

  • Advance Care Planning*
  • Advance Directives
  • Decision Making
  • Humans
  • Kidney Failure, Chronic* / psychology
  • Kidney Failure, Chronic* / therapy
  • Palliative Care
  • Patient Care Team*
  • Patient-Centered Care*
  • Renal Dialysis*