INTRODUCTION: Healthcare for patients with advanced chronic kidney disease (ACKD) on conservative treatment very often poses healthcare problems that are difficult to solve. Many patients are elderly and have mobility problems, and it is very difficult for them to travel to hospital. At the end of 2011, we began a programme based on the care and monitoring of these patients by Primary Care teams. MATERIAL AND METHOD: ACKD patients who opted for conservative treatment were offered the chance to be cared for mainly at home by the Primary Care doctor, under the coordination of the Palliative Care Unit and the Nephrology Department. RESULTS: During 2012 and 2013, 50 patients received treatment in this programme. Mean age: 81 years, Charlson age-comorbidity index: 10 and mean glomerular filtration rate: 11.8ml/min/1.73.m². The mean patient follow-up time (until death or until 31/12/2013) was 184 days. During this period, 44% of patients did not have to visit the hospital’s Emergency Department and 58% did not require hospitalisation. 29 of the 50 patients died after a mean time of 163 days on the programme; 14 (48%) died at home. CONCLUSIONS: Our experience indicates that with the support of the Palliative Care Unit and the Nephrology Department, ACKD patients who are not dialysis candidates may be monitored at home by Primary Care.
INTRODUCTION:  Healthcare for patients with advanced chronic kidney disease (ACKD) on conservative treatment very often poses healthcare problems that are difficult to solve. Many patients are elderly and have mobility problems, and it is very difficult for them to travel to hospital. At the end of 2011, we began a programme based on the care and monitoring of these patients by Primary Care teams.  MATERIAL AND METHOD:  ACKD patients who opted for conservative treatment were offered the chance to be cared for mainly at home by the Primary Care doctor, under the coordination of the Palliative Care Unit and the Nephrology Department.  RESULTS:  During 2012 and 2013, 50 patients received treatment in this programme. Mean age: 81 years, Charlson age-comorbidity index: 10 and mean glomerular filtration rate: 11.8ml/min/1.73.m². The mean patient follow-up time (until death or until 31/12/2013) was 184 days. During this period, 44% of patients did not have to visit the hospital’s Emergency Department and 58% did not require hospitalisation. 29 of the 50 patients died after a mean time of 163 days on the programme; 14 (48%) died at home.  CONCLUSIONS:  Our experience indicates that with the support of the Palliative Care Unit and the Nephrology Department, ACKD patients who are not dialysis candidates may be monitored at home by Primary Care.
Authors: Vincenzo Livio Malavasi; Anna Chiara Valenti; Sara Ruggerini; Marcella Manicardi; Carlotta Orlandi; Daria Sgreccia; Marco Vitolo; Marco Proietti; Gregory Y H Lip; Giuseppe Boriani Journal: J Clin Med Date: 2022-02-08 Impact factor: 4.241