The Symptoms Prevalence, Medical Interventions, and Health Care Service Needs for Patients With End-Stage Renal Disease in a Renal Palliative Care Program

Am J Hosp Palliat Care. 2016 Dec;33(10):952-958. doi: 10.1177/1049909115598930. Epub 2015 Aug 9.

Abstract

A retrospective study was conducted to evaluate the symptoms prevalence and interventions initiated in the last 2 weeks of life, health care service utilization, and causes of death of patients with end-stage renal disease (ESRD under a renal palliative care (RPC) program. A total of 335 RPC patients were included, of which 226 patients died during the study period. The 5 most prevalent symptoms were dyspnea (63.7%), fatigue (51.8%), edema (48.2%), pain (44.2%), and anorexia (38.1%); and the 5 most prevalent interventions initiated were oxygen (69.5%), parenteral infusion (67.3%), antibiotics (53.5%), bladder catheterization (44.7%), and analgesic (39.8%) in the last 2 weeks of life. Each patient received 3.5 ± 4.4 outpatient clinic visit, 3.4 ± 10.3 home care visits, and 3.1 ± 2.7 hospital admissions. Besides ESRD (51.8%), the most common causes of death were cardiovascular events (18.6%) and infection (17.2%).

Keywords: cause of death; end of life; end-stage renal disease; health care utilization; palliative care; symptoms.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anorexia / etiology
  • Anorexia / therapy
  • Cause of Death
  • Dyspnea / etiology
  • Dyspnea / therapy
  • Edema / etiology
  • Fatigue / etiology
  • Female
  • Health Services / statistics & numerical data*
  • Home Care Services / statistics & numerical data
  • Humans
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Male
  • Pain / etiology
  • Pain Management / methods
  • Palliative Care / methods*
  • Palliative Care / statistics & numerical data
  • Quality of Life
  • Retrospective Studies
  • Terminal Care / methods*
  • Terminal Care / statistics & numerical data