Abstract

People with advanced chronic kidney disease (CKD) have high mortality; substantial physical, emotional and spiritual suffering; and tremendous end-of-life (EOL) care needs. However, their illness trajectories and needs differ from those with advanced cancer and current palliative care models do not meet these needs. Over the last two decades, much research and evidence on advance care planning (ACP) and EOL issues in CKD have accumulated. As a result, integrated renal palliative care services are slowly being developed internationally. Kidney Disease: Improving Global Outcomes (KDIGO), the independent, not-for-profit, organisation that conducts formal international guideline development in CKD, agrees that a comprehensive analysis of ACP and EOL/supportive care for CKD patients is timely and represents an area of great clinical need. KDIGO is therefore partnering with experts from around the world to hold the first consensus forum on renal supportive care. The goal is to (1) summarise the state of knowledge; (2) discuss what recommendations can be derived from the available knowledge; and (3) assess what needs to be undertaken to improve the evidence-base for ACP and EOL clinical management. The overall aim is to work towards global guidelines for the implementation of renal supportive care. This would help improve worldwide practice, referral, and overall access to ACP and palliative care services for patients with CKD. This session will highlight these recent advances in ACP and EOL care and will suggest how new knowledge may be integrated into care for patients with advanced CKD.