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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Chronic Kidney Disease (CKD) is a progressive, life-threatening condition that causes significant morbidity and mortality. Throughout the disease process, even before end-stage, patients can benefit from a palliative approach with multidimensional management.
The palliative care (PC) in nephrology outpatient clinic started in December 2023. The project was developed through a partnership between the hospital's PC and nephrology teams. Furthermore, a commitment to education and training was set with the participation of nephrology and internal medicine residents.
The project's main goal, through a multidisciplinary evaluation of selected patients, is to help in care planning aimed at improving quality of life, symptom control, construction of advance directives (AD) and family support.
Validated tools supported by the literature are used as prognostic tools to assist in establishing the goal of care, tailored to this patient profile. Referrals are made by the attending nephrologists of CKD 4-5 patients. Criteria such as dialysis refusal, age over 75 with multiple comorbidities, uncontrolled symptoms, and pre-dialysis patients who are clearly deteriorating are taken into consideration. To define the most appropriate path, identifying poor prognostic criteria helps in defining the goal of care. Prognostic tools such as the Surprise Question, the modified Chalson Scale, Karnofsky, Rein score, Coenh 6-month, among others, associated with wishes, desires, and values of the patient, assist in the decision-making process, which should be shared using communication techniques.
Since the beginning of activities, almost 40 patients have been assisted. Of those, 25.9% died, 7.4% were discharged, and 66.7% are being monitored. Regarding functionality, 50% have a KPS <50%. 53.6% are still developing a care plan, and 39.3% have been assigned palliative care.
It is known that patients in advanced stages of CKD can benefit from conservative approaches or renal replacement therapy (RRT) modalities. In our experience 66.6% of outpatients are not on RRT, and of those 50% opted not to undergo RRT (29% due to AD and 71% due to poor prognosis conditions).
In patients defined as palliative, based on previous assessments, as CKD progresses to the end-stage, regardless of the previous path, it is necessary to reevaluate the treatment plan and align with the team, family, and the patient themselves. Avoiding futile measures, adequately controlling symptoms, and providing appropriate support are the most suitable approaches at this time. Of all the deaths in the project, 57.1% of patients continued on conservative treatment until end of life.
PC in CKD is a complex matter. Clinical judgment, refined through the use of prognostic scales, aligned with patients' wishes and values, allows for the development of an individualized and proportionate care plan.
Due to the chronic nature of the disease and its tendency to be associated with multiple comorbidities and a high symptom burden, which is usually multifactorial, patients with CKD are eligible for palliative care during the illness process. An interdisciplinary and multidimensional approach, combined with pharmacological prescription or deprescription, should be adopted to manage symptoms and improve quality of life.
