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Abstract: FR-PO448

Advance Care Planning in Patients with Advanced CKD on Hemodialysis in the Hospital Setting

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Sanchez Hernandez, Rosa, Hospital General de Villalba, Collado Villalba, Madrid, Spain
  • Dahl, Alicia Bárcena, Hospital General de Villalba, Collado Villalba, Madrid, Spain
  • Gonzalez-Marino, Rocio Zamora, Hospital General de Villalba, Collado Villalba, Madrid, Spain
  • Rodriguez Osorio Jimenez, Laura, Hospital General de Villalba, Collado Villalba, Madrid, Spain
  • Muñoz Sánchez, Ana, Hospital General de Villalba, Collado Villalba, Madrid, Spain
Background

To explore the wishes and preferences of patients with advanced chronic kidney disease (ACKD) who receive hemodialysis through the application of the instrument "Dodecahedron of advance care planning" to improve the approach and medical care of these patients , promote communication between them and the healthcare professionals who attend to them.Advance care planning in patients with advanced chronic kidney disease on hemodialysis in the hospital setting.

Methods

Patients with advanced chronic kidney disease (ACKD) admitted to the Hemodialysis program of the General Hospital of Villalba were included. Demographic variables, knowledge about CAP and conversations about the end of life, comorbidity with the Charlson Index, and cognitive status using the Pfeiffer scale were collected. In addition, the dodecahedron of advance care planning was used as a clinical instrument through an interview.

Results

70 patients were included; 35 completed PAC, 54.3% men and 45.7% women. Median age 72 years (44-89). Of all with Charlson Index >5, 14.2% had depression. The median dialysis time was 36 months (3-276). 100% had not discussed the end of life with their doctor, and 25.75% had with their main caregiver. 31.4% NECPAL positive. The wishes of the patients were: 91.4% "to be cared for with respect and kindness," 77.7% expect the best to be done at each moment of their illness, 25.4% did not want to talk about the end of life, 77.1% did not want to suffer in pain, 60% "not be a burden to their families," 100% wanted to die accompanied by their family. 48.6% wanted to die at home, 14% in hospital, and 37.1% did not care. 80% wanted to be connected to machines "if their recovery is reasonable," 68.6% wanted palliative sedation for refractory symptoms, 97.1% wanted to be reminded "as a good person," and 85.7% were believers that gave meaning to his illness.

Conclusion

Most patients at the end of life wish not to be a burden to their family, to die accompanied, without pain, and at home. The dodecahedron tool is helpful for CAP in HD; it facilitates communication and decision-making aspects and has a positive impact on the patient.