Table 2.

Models of kidney palliative care and representative kidney palliative care interventions

Kidney Palliative Care InterventionModel of Kidney Palliative CareStaffing/InterventionAdditional Services Provided
Baystate Medical Center (22)Scaling primary KPCTraining for existing dialysis unit social workers and nephrologistsFacilitate advance care planning discussions with social workers and nephrologists for patients on dialysis with poorer prognosis
University of New Mexico (22)60 min lecture, review of training tape, didactic resources disseminated; social workers received additional 1-d intensive training.
NephroTalk (23)Scaling primary KPCAcademic nephrologists trained to teach KPC skillsCurricular intervention that addresses nephrology fellowship training gap in teaching KPC skills
Zuckerberg SF General HospitalScaling primary KPCClinic staffed by academic nephrologist who completed palliative care courses, physician extenders, nurse, dietician, social workerFellow education (direct observation in clinic, KPC lectures, serious illness communication skills workshops)
Kidney CARES, NYU (31)Embedded KPCNephrologist with palliative care training, partnership with Integrative Health Services, access to Nephrology Clinic staffEmbedded KPC provider addresses complex symptoms and patient-centered communication/decision making alongside routine kidney care, including comprehensive conservative care.
Renal Supportive Care Clinic, University of PittsburghEmbedded KPCNephrologist with palliative care training; access to Nephrology Clinic staff, Palliative Care home programs, and psychological resourcesEmbedded KPC provider addresses complex symptoms and patient-centered communication/decision making alongside routine kidney care, including comprehensive conservative care.
SPIRIT intervention, UNC (34)Embedded KPCNurses undergo 3.5 d training in psychoeducational interventionAdvance care planning with dyads of patients on dialysis and their surrogates over two sessions in the dialysis facility and at home
Northwest Kidney Centers ESCOMobile/home-based KPCNephrologist with palliative care training, full-time social worker, and nurseKPC team addresses complex patient-centered communication/decision making and symptom management in the dialysis facility and/or place of residence alongside routine kidney care.
Year-long palliative care training for social worker and nurse
Conservative Care Program, University of Calgary (44)Embedded KPC and mobile/home-based KPCNephrologist with palliative care training, nurse dedicated to advance care planning, two half-time nurses for comprehensive conservative care, access to a social worker and dieticianEmbedded clinic and home visit support for patients considering comprehensive conservative care
Kidney-specific symptom management support both before and during enrollment in hospice
Alberta Health Services (45)State/provincial KPC (KPC integrated in governmental health systems)Provincial guidelines outline a comprehensive conservative care pathway for primary care providers and kidney care professionalsScale comprehensive conservative care provision within Canadian provincial health services via centralized tools and pathways
British Columbia Renal Agency (46)
Renal Supportive Care, Australia (2)State/provincial KPC (KPC integrated in governmental health systems)Embedded KPC model with palliative care specialist, senior KPC nurse, and social worker at each Renal UnitComprehensive conservative care delivered by embedded KPC team at each Renal Unit
Concurrent KPC services for patients on dialysis
KPC services scaled within Australian state health service
  • KPC, kidney palliative care; SF, San Francisco; NYU, New York University; SPIRIT, Sharing Patient's Illness Representations to Increase Trust; UNC, University of North Carolina; CARES, Comprehensive Advanced Renal Disease and ESKD Support; ESCO, ESKD Seamless Care Organization.