Supportive Care: Integration of Patient-Centered Kidney Care to Manage Symptoms and Geriatric Syndromes

Dialysis care is often associated with poor outcomes including low quality of life (QOL). To improve patient-reported outcomes, incorporation of the patient's needs and perspective into the medical care they receive is essential. This article provides a framework to help clinicians integrate symptom assessment and other measures such as QOL and frailty scores into a clinical approach to the contemporary supportive care of patients with advanced CKD. This approach involves ( 1 ) defining our understanding of kidney supportive care, patient-centered dialysis, and palliative dialysis; ( 2 ) understanding and recognizing common symptoms associated with advanced CKD; ( 3 ) discussing the concepts of physical function, frailty, and QOL and their role in CKD; and ( 4 ) identifying the structural and process barriers that may arise when patient-centered dialysis is being introduced into clinical practice.