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FRIDAY, Aug. 30, 2019 (HealthDay News) — More intensive patterns of end-of-life care are associated with lower family ratings of quality of care among patients with advanced chronic kidney disease (CKD), according to a study published online Aug. 29 in the Clinical Journal of the American Society of Nephrology<\/i>.<\/p>\n
Claire A. Richards, Ph.D., R.N., from the Veterans Affairs Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, and colleagues designed a retrospective study among a national cohort of 9,993 veterans with advanced CKD who died between 2009 and 2015.<\/p>\n
The researchers found that 55, 12, and 34 percent of patients did not receive dialysis, received acute dialysis, and received maintenance dialysis, respectively. More intensive patterns of end-of-life care were seen for patients treated with acute or maintenance dialysis versus those not treated with dialysis. Lower overall family ratings of end-of-life care were seen with receipt of maintenance dialysis and more intensive patterns of end-of-life care after adjustment for patient and facility characteristics, while higher overall ratings were seen in association with receipt of palliative care and hospital services. After additional adjustment for end-of-life treatment patterns, the correlation between maintenance dialysis and overall quality of care was attenuated.<\/p>\n
“A deeper understanding of what drives both patterns and quality of end-of-life care among patients with advanced CKD may help to identify opportunities to improve care for members of this population,” the authors write.<\/p>\n
One author disclosed financial ties to the medical technology and kidney dialysis industries.<\/p>\n
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