Palliative Care in Nephrology: The Work and the Workforce

  • Samantha L. Gelfand
    Address correspondence to Samantha L. Gelfand, MD, 55 Fruit Street, Founders 600, Boston, MA 02114.
    Division of Palliative Care & Geriatric Medicine, Massachusetts General Hospital, Boston, MA

    Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA

    Harvard Medical School, Boston, MA
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  • Jane Schell
    Section of Palliative Care and Medical Ethics, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA

    Division of Renal-Electrolyte, University of Pittsburgh School of Medicine, UPMC Health System, Pittsburgh, PA
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  • Nwamaka D. Eneanya
    Renal Electrolyte and Hypertension Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA

    Palliative and Advanced Illness Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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      Kidney palliative care is a growing subspecialty of clinical practice, education, and research in nephrology. It is an essential aspect of care for patients across the continuum of advanced kidney disease who have high symptom burden, multidimensional communication needs, and limited life expectancy. Training in kidney palliative care can occur in a variety of ways, from didactic curricula and clinical experiences embedded in nephrology fellowship training to the pursuit of additional dedicated fellowship training in palliative care. At this time, a minority of nephrologists pursue formal fellowship training in specialty palliative care. This article will discuss opportunities and challenges in building a skilled workforce that will address the palliative needs of patients living with advanced kidney disease.

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