Treatment decision-making in advanced kidney disease: an international collaborative workshop on future directions

By Dr Lucy Selman, Associate Professor in Palliative and End of Life Care, Centre for Academic Primary Care, University of Bristol

On Thursday 8 June 2023, an expert meeting was held at the University of Bristol, on treatment decision-making in advanced kidney disease. The meeting brought together renal and palliative care clinicians and researchers specialising in the area from across the UK with colleagues from Harvard University and Brigham and Women’s Hospital, with two guests from Boston coming to Bristol to attend in person.

The aim of the event was to share research and clinical practice models related to treatment decision-making in advanced kidney disease – an area in which the partnering teams have complementary expertise.

The event was led by Dr Lucy Selman, Associate Professor of Palliative and End-of-Life Care at the University of Bristol in collaboration with Professor James Tulsky, Professor of Medicine at Harvard University and Poorvu Jaffe Chair at the Dana-Farber Cancer Institute. It was funded by Bristol International Research Collaboration Activities (BIRCA) and the National Institute for Health  and Care Research. A total of 20 people attended.

The day began with presentations, sharing research and clinical work with people at high risk of developing kidney failure. This included presentations on the UNPACK study, the PREPARE RCT, the OSCAR study, and the KidneyPal model of integrated palliative care and nephrology (picture 1).

This was followed by a Keynote Lecture from Professor Tulsky on ‘Enhancing Communication between Clinicians and Seriously Ill Patients: From Research to Pedagogy to Practice’ (picture 2). The lecture was recorded and is available for download here.

The second half of the day consisted of brainstorming sessions to identify research priorities in the area, with the longer term aim of developing a position statement on communication about treatment options and advance care planning for older people with advanced kidney disease.

The international expert meeting created a constant flow of invigorated discussions, continuing throughout the day, despite the warm weather. Attendees reported feeling energised by the meeting, and were enthusiastic about taking the research priorities forward.

Picture 1: The KidneyPal team from Boston (in person and online) presenting their clinical model
Picture 2: Professor James Tulsky taking questions from the in person and online audience of his webinar

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