Chapter 53
Prognostication in Advanced Chronic Kidney Disease
Katharine L. Cheung,
Cecile Couchoud,
Katharine L. Cheung
Division of Nephrology, Department of Medicine, The University of Vermont, Burlington, USA
Search for more papers by this authorCecile Couchoud
REIN Registry Department, Agence de la biomédecine, Saint Denis – La Plaine, France
Search for more papers by this authorKatharine L. Cheung,
Cecile Couchoud,
Katharine L. Cheung
Division of Nephrology, Department of Medicine, The University of Vermont, Burlington, USA
Search for more papers by this authorCecile Couchoud
REIN Registry Department, Agence de la biomédecine, Saint Denis – La Plaine, France
Search for more papers by this authorBook Editor(s):Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS,
Donald A. Molony MD,
Giovanni F.M. Strippoli MD, PhD, MPH, MM (Epi),
Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS
Matthew Flinders Distinguished Professor Vice President and Executive Dean
College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorDonald A. Molony MD
Professor of Medicine Distinguished Teaching Professor of the University of Texas System
Division of Renal Diseases and Hypertension AND Center for Clinical Research and Evidence-based Medicine, McGovern Medical School University of Texas, Houston, TX, USA
Search for more papers by this authorGiovanni F.M. Strippoli MD, PhD, MPH, MM (Epi)
Professor of Nephrology Adjunct Professor of Epidemiology
Department of Emergency and Organ Transplantation – University of Bari, Bari, Italy
School of Public Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorFirst published: 18 November 2022
Summary
Prognostication is a critical component of the care of patients with advanced chronic kidney disease. This chapter focuses on prognostication with short-term mortality as the goal, given the context of kidney supportive care. Clinicians, patients, and families may also be interested in prognostication of functional status, symptom burden, quality of life, hospitalizations, place of death, and capabilities. The immediate goal of prognostication is to share information with the patient and family. Prognostication has a role in shared decision-making such that it can reduce regret or discordant treatment plans. Prognostication may also improve identification of high-risk patients and thus facilitate access to kidney supportive care and comprehensive conservative care for these patients and, if appropriate, the discussion of withdrawal of dialysis and the organization of a timely transition to hospice. The chapter provides the use of prognostic models in kidney supportive care.
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