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Enfermería Nefrológica
On-line version ISSN 2255-3517Print version ISSN 2254-2884
Abstract
AGUILERA FLOREZ, Ana Isabel et al. Assessment of the choice of conservative treatment in chronic kidney disease. Enferm Nefrol [online]. 2019, vol.22, n.1, pp.52-58. ISSN 2255-3517. https://dx.doi.org/10.4321/s2254-28842019000100008.
Introduction:
Conservative treatment is a treatment option in chronic kidney disease. The election of this treatment is determined by patient and / or the family.
Objective:
The objective of the study was to analyze the process of choosing conservative treatment, identify the patient profile, the patient’ survival and who communicate the election.
Material and Method:
Observational, retrospective study. Patients who chose conservative treatment between 2010-2017 were included. The data were obtained from nursing records in clinical history. Demographic variables, survival, Charlson Comorbidity Index, Barthel Index and patient values were collected using the Values Cards tool.
Resultados:
The sample was 95 patients, 41.05% men, mean age 82.36±9 years, 27.37% institutionalized. The family reported the choice in 62.11% of the cases. The mean glomerular filtration rate at the beginning of the information was 11.53±2.73 ml/min, the median of Charlson index: 8 (13-3), median of Barthel index: 55 (100-0) points. In the process of contrasting values, the most chosen card was “health personnel responsible for treatment”. The median survival was 496.19±553.8 days. Men and the institutionalized live less, without significant difference. The risk of death is greater, as the Charlson index increases and the glomerular filtration rate decreases (p=0.01).
The family announced the election to continue conservative treatment in 62.11% of cases.
Conclusions:
Patients who opts for conservative treatment are elderly persons, dependents, with comorbidities, average survival of 18 months, and in more than half of the cases, the family is the one that communicates the decision to opt for that treatment.
Keywords : chronic kidney disease; conservative treatment; decision making; surviva; information; patient preferences.