• Vanessa Grubbs, Alvin H Moss, Lewis M Cohen, Michael J Fischer, Michael J Germain, S Vanita Jassal, Jeffrey Perl, Daniel E Weiner, Rajnish Mehrotra, and Dialysis Advisory Group of the American Society of Nephrology.
• Division of Nephrology, University of California, San Francisco, San Francisco, California; Division of Nephrology, San Francisco General Hospital, San Francisco, California; grubbsv@medsfgh.ucsf.edu.
• Clin J Am Soc Nephrol. 2014 Dec 5; 9 (12): 2203-9.

AbstractAs the importance of providing patient-centered palliative care for patients with advanced illnesses gains attention, standard dialysis delivery may be inconsistent with the goals of care for many patients with ESRD. Many dialysis patients with life expectancy of <1 year may desire a palliative approach to dialysis care, which focuses on aligning patient treatment with patients' informed preferences. This commentary elucidates what comprises a palliative approach to dialysis care and describes its potential and appropriate use. It also reviews the barriers to integrating such an approach into the current clinical paradigm of care and existing infrastructure and outlines system-level changes needed to accommodate such an approach. Copyright © 2014 by the American Society of Nephrology.

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