Decision-making in patients with cancer and kidney disease

Adv Chronic Kidney Dis. 2014 Jan;21(1):72-80. doi: 10.1053/j.ackd.2013.07.005.


Thoughtful decision-making in a patient with cancer and kidney disease requires a comprehensive discussion of prognosis and therapy options for both conditions framed by the individual's preferences and goals of care. An estimate of overall prognosis is generated that includes the patient's clinical presentation and parameters associated with adverse outcomes, such as age, performance status, frailty, malnutrition, and comorbidities. Empathic communication of this information using a shared decision-making approach can lead to an informed decision that respects patient autonomy and is consistent with the patient's "big-picture" goals and personal values.

Keywords: Dialysis; Onconephrology; Palliative care; Prognosis; Shared decision-making.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / complications
  • Acute Kidney Injury / therapy
  • Communication
  • Decision Making*
  • Humans
  • Kidney Diseases / complications
  • Kidney Diseases / therapy*
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Neoplasms / complications
  • Neoplasms / therapy*
  • Palliative Care*
  • Patient Care Planning*
  • Patient Participation*
  • Physician-Patient Relations
  • Prognosis
  • Renal Dialysis
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / therapy