Epilogue
Nandini Vallath, Frank BrennanIndian Journal of Palliative Care 2021 27(5):43-44 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Nandini Vallath Frank Brennan Source Type: research
End of life care in end-stage kidney disease
Ravindra Attur Prabhu, Naveen Salins, Bharathi , Georgi AbrahamIndian Journal of Palliative Care 2021 27(5):37-42
There is a rise in burden of end-stage renal disease globally and in India. The symptom burden, prognosis, and mortality in chronic kidney disease closely mimics that of cancer. However, the palliative and end of life care needs of these patients are seldom addressed. A consensus opinion statement was developed outlining the provision of end of life care in end-stage kidney disease. Recognition of medical futility, consensus on medical futility, and cessation of potentially inappropriate therapies and medicati...
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Ravindra Attur Prabhu Naveen Salins Bharathi Georgi Abraham Source Type: research
Shared decision-making, advance care planning for chronic kidney disease patients
Jayita Deodhar, Shankar Prasad Nagaraju, Ashok L Kirpalani, Ajith M NayakIndian Journal of Palliative Care 2021 27(5):33-36
Advance care planning (ACP) is a process by which clinicians together with patients and families reflect on and outline care goals to inform current and future care. ACP or shared decision-making is not only about key medical decisions, such as decision about continuing dialysis, or agreement for “not for resuscitation” order when in hospital. The importance of its role in chronic kidney disease (CKD) patients is less known and not being well practiced in our country. When d...
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Jayita Deodhar Shankar Prasad Nagaraju Ashok L Kirpalani Ajith M Nayak Source Type: research
Withdrawal from dialysis: Why and when ?
Mohan V Bhojaraja, Pankaj Singhai, MM Sunil Kumar, M SreelathaIndian Journal of Palliative Care 2021 27(5):30-32
Patients with end-stage kidney diseases may request for withdrawal of dialyses for many reasons. Healthcare practitioners frequently puzzled by ethical dilemma of respecting patient's wishes and beneficence of continuing dialysis. Shared decision-making and negotiating goal of care help in decision-making in patients' interests. Proactive identification guidelines that may be used for screening help in weighing options of dialysis and conservative care during progressive decline of clinica...
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Mohan V Bhojaraja Pankaj Singhai MM Sunil Kumar M Sreelatha Source Type: research
Symptom management among patients with chronic kidney disease
Seema Rajesh Rao, Nandini Vallath, Vishwanath Siddini, Tukaram Jamale, Divya Bajpai, Nitish Nitin Sancheti, Dharshan RangaswamyIndian Journal of Palliative Care 2021 27(5):14-29
Patients with chronic kidney disease (CKD) experience high symptom burden, both physical and psychological, that is underrecognized and undertreated. The high symptom burden significantly impacts the quality of life for patients and their families. This review enumerates the various physical and psychological symptoms that patients with CKD often experience and guides in the management of these symptoms. This review follows the recommended interna...
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Seema Rajesh Rao Nandini Vallath Vishwanath Siddini Tukaram Jamale Divya Bajpai Nitish Nitin Sancheti Dharshan Rangaswamy Source Type: research
Comprehensive conservative care in end-stage kidney disease
Gayatri Palat, Srinivas Vinayak Shenoy, Lakshmitha Shetty, Sivakumar VishnubhotlaIndian Journal of Palliative Care 2021 27(5):11-13
In patients with end-stage kidney disease (ESKD), when there maybe situations where dialysis does not offer benefits in terms of survival or health-related quality of life, dialysis should not be viewed as the default therapy. Such patients can be offered comprehensive conservative care as an alternative to dialysis. Conservative (nondialytic) management of ESKD includes careful attention to fluid balance, treatment of anemia, correction of acidosis and hyperkalemia, blood pressure, and calci...
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Gayatri Palat Srinivas Vinayak Shenoy Lakshmitha Shetty Sivakumar Vishnubhotla Source Type: research
Decision-making around commencing dialysis
Indu Ramachandra Rao, Nandini Vallath, YJ Anupama, Krishan Lal Gupta, Krithika S RaoIndian Journal of Palliative Care 2021 27(5):6-10
The decision regarding dialysis initiation is complex. Awareness that renal replacement therapy should not be regarded as default therapy for every patient with advanced renal failure is necessary. Decision to initiate dialysis and modality should be individualized in a shared decision-making process involving the treating nephrologist and the patient. Patients should receive predialysis education early in the course of chronic kidney disease so as to help prepare them well in advance for t...
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Indu Ramachandra Rao Nandini Vallath YJ Anupama Krishan Lal Gupta Krithika S Rao Source Type: research
Developing supportive care services for patients with kidney failure: An idea whose time has come
Vivekanand JhaIndian Journal of Palliative Care 2021 27(5):3-5
The number of patients developing kidney failure is increasing globally including in India. Dialysis is not the most optimal treatment for a number of these patients such as the elderly, the frail and those with multiple comorbidities and limited life expectancy. Moreover, some patients may prefer not to undergo dialysis. Supportive care focused on symptom management and improving the quality of life is a legitimate treatment option in these situations. It can be delivered alongside dialysis or to patients who choose to receive only conservative care and is be...
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Vivekanand Jha Source Type: research
Foreword for renal supportive care in India
Narayan PrasadIndian Journal of Palliative Care 2021 27(5):2-2 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: Narayan Prasad Source Type: research
Prologue
H Sudarshan BallalIndian Journal of Palliative Care 2021 27(5):1-1 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - May 30, 2021 Category: Palliative Care Authors: H Sudarshan Ballal Source Type: research
Bayesian adaptive design scope of utilizing it for research in palliative care
Abhijit Nair, Praneeth Suvvari, Srinivas Shyam Prasad Mantha, Basanth Kumar RayaniIndian Journal of Palliative Care 2021 27(1):186-187 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - February 17, 2021 Category: Palliative Care Authors: Abhijit Nair Praneeth Suvvari Srinivas Shyam Prasad Mantha Basanth Kumar Rayani Source Type: research
Spirituality among the terminally ill in a rural hospice program
Brian W JonesIndian Journal of Palliative Care 2021 27(1):183-185
Rural populations are unique compared to their urban and suburban counterparts in relation to both healthcare mindsets and spiritual needs. Rural populations tend to be more religious, more accepting of death, and less likely to pursue aggressive care at the end-of-life. This research project looked at the utilization of chaplaincy services among a rural, southwestern hospice population. It also examined outcomes related to patient and family satisfaction surrounding spiritual themes. Results were compared to 1700 other hospice programs. Areas where there w...
Source: Indian Journal of Palliative Care - February 17, 2021 Category: Palliative Care Authors: Brian W Jones Source Type: research
Sequential supraclavicular brachial plexus and stellate ganglion neurolysis for upper limb pain in metastatic breast cancer
We describe a case of severe neuropathic pain in brachial plexopathy in a middle-aged woman caused by metastatic breast cancer that was managed by chemical neurolysis of brachial plexus. Residual pain was treated by neurolysis of stellate ganglion due to the presence of sympathetic pain. This case report highlights the importance of the dual nature of pain and its management by chemical neurolysis in severe refractory neuropathic and sympathetic mediated pain. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - February 17, 2021 Category: Palliative Care Authors: Dhruv Jain Titiksha Goyal Anil Kumar Paswan Nimisha Verma Source Type: research
Collusion: The facade and its implications on total pain management in palliative care
Bincy Mathew, Bidhu Kalyan Mohanti, Saipriya Tewari, Vedant Kabra, Pushpinder Gulia, Peush Bajpai, Anusheel MunshiIndian Journal of Palliative Care 2021 27(1):176-179
Collusion is an unharmonious bond between the doctor and a patient or between patients and caregivers. This case report exemplifies one such experience and highlights the hurdles we face when dealing with collusion. A 31-year-old woman was diagnosed with rectal carcinoma during her pregnancy and underwent diversion colostomy (for intestinal obstruction) followed by neoadjuvant chemoradiation after delivery. Later, she was diagnosed with metastatic disease an...
Source: Indian Journal of Palliative Care - February 17, 2021 Category: Palliative Care Authors: Bincy Mathew Bidhu Kalyan Mohanti Saipriya Tewari Vedant Kabra Pushpinder Gulia Peush Bajpai Anusheel Munshi Source Type: research
High-dose continuous infusion of tranexamic acid for controlling life-threatening bleed in advanced cancer patients
Shrikant AtreyaIndian Journal of Palliative Care 2021 27(1):172-175
Life-threatening bleeding although uncommon in palliative care is associated with significant distress among patients and family. The current guidelines emphasize the need for identification of a patient with early signs of bleeding and providing assurance and comfort care to patients and family in case of an event. There is very little known about the role of high dose of tranexamic acid, a lysine analog in controlling the bleeding irrespective of the underlying pathophysiology of the bleed. Tranexamic acid is known to competitively block the lysine-bind...
Source: Indian Journal of Palliative Care - February 17, 2021 Category: Palliative Care Authors: Shrikant Atreya Source Type: research
