ArticleClinical and experimental nephrology2026
End-of-life of conservative kidney management in older CKD patients undergoing comprehensive geriatric assessment.
Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comprehensive geriatric assessment and optimisation in advanced chronic kidney disease: a systematic review and narrative synthesis examining clinical outcomes and decision-making.BMC nephrology · 2026Pooled it
- Conditions identified by common comprehensive geriatric assessment measures and subsequent acute care among adults with SLE.Lupus science & medicine · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany older chronic kidney disease (CKD) patients with frailty do not tolerate renal replacement therapy (RRT). Although conservative kidney management (CKM) has become popular in Europe and America, end-of-life care systems, including palliative care intervention methods, have not been established.
methodsWe analyzed a total of 20 CKD patients aged 65 years or older who underwent comprehensive geriatric assessment (CGA), selected CKM based on advanced care planning (ACP), and died of end-stage renal disease.
resultsThe mean age at death was 87.4 years. At the time of the CKM decision, BUN was 85.6 mg/dL, Cre was 5.2 mg/dL, eGFR was 10.9, clinical frailty scale (CFS) was 6.4, dementia assessment sheet for community-based care systems (DASC-21) was 55.6, and time from decision to death was 88 days. Eleven patients required sedatives for delirium and eight patients required narcotics for dyspnea or pain. Patients who required sedation were younger, had lower DASC-21, and were significantly more likely to have cardiovascular disease and diabetes than those who did not. Patients who required narcotics were younger, had lower CFS, and were significantly more likely to have cardiovascular disease than those who did not require narcotics.
conclusionsESRD patients who opted for CKM requiring palliative care narcotic or sedative intervention were characterized by young older patients with less dementia and frailty and those with cardiovascular disease. This study shows predictors of the need for palliative treatment at the end of life for CKM, which could be useful information for improving end-of-life care for CKM.
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