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      Chronic Kidney Disease, Spirituality and Religiosity: A Systematic Overview with the List of Eligible Studies

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          Abstract

          Chronic Kidney Disease (CKD) has a tremendous psychological burden, which sometimes is overlooked or underestimated in the daily clinical routine practice, since in the health care process physicians prefer to focus on the objective aspects of the pathology. In this contribution, we make a systematic overview of the relationship between spirituality/religiosity and CKD, an emerging theme which only recently has raised interest from the scientific community despite its importance. We investigate different variables, axis and categories (from the quality of life to customer’s satisfaction, treatment adherence and therapeutic alliance, clinical parameters, as well as overall survival, and coping strategies adopted by the patient). Moreover, we underpin the principal clinically relevant implications (like the possibility of psycho-therapeutic interventions based on the spiritual and religious attitudes of the patient) and we discuss the main gaps, methodological barriers and difficulties in the field, fostering and advocating further research and clinical studies. This last aspect, together with the quality assessment of the studies, will be further explored in the second part of the study.

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          Most cited references58

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          Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO).

          Cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) is high, and the presence of CKD worsens outcomes of cardiovascular disease (CVD). CKD is associated with specific risk factors. Emerging evidence indicates that the pathology and manifestation of CVD differ in the presence of CKD. During a clinical update conference convened by the Kidney Disease: Improving Global Outcomes (KDIGO), an international group of experts defined the current state of knowledge and the implications for patient care in important topic areas, including coronary artery disease and myocardial infarction, congestive heart failure, cerebrovascular disease, atrial fibrillation, peripheral arterial disease, and sudden cardiac death. Although optimal strategies for prevention, diagnosis, and management of these complications likely should be modified in the presence of CKD, the evidence base for decision making is limited. Trials targeting CVD in patients with CKD have a large potential to improve outcomes.
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            End-of-life care preferences and needs: perceptions of patients with chronic kidney disease.

            Despite high mortality rates, surprisingly little research has been done to study chronic kidney disease (CKD) patients' preferences for end-of-life care. The objective of this study was to evaluate end-of-life care preferences of CKD patients to help identify gaps between current end-of-life care practice and patients' preferences and to help prioritize and guide future innovation in end-of-life care policy. A total of 584 stage 4 and stage 5 CKD patients were surveyed as they presented to dialysis, transplantation, or predialysis clinics in a Canadian, university-based renal program between January and April 2008. Participants reported relying on the nephrology staff for extensive end-of- life care needs not currently systematically integrated into their renal care, such as pain and symptom management, advance care planning, and psychosocial and spiritual support. Participants also had poor self-reported knowledge of palliative care options and of their illness trajectory. A total of 61% of patients regretted their decision to start dialysis. More patients wanted to die at home (36.1%) or in an inpatient hospice (28.8%) compared with in a hospital (27.4%). Less than 10% of patients reported having had a discussion about end-of-life care issues with their nephrologist in the past 12 months. Current end-of-life clinical practices do not meet the needs of patients with advanced CKD.
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              Psychosocial factors in dialysis patients.

              P L Kimmel (2001)

                Author and article information

                Journal
                Health Psychol Res
                Health Psychol Res
                HPR
                Health Psychology Research
                PAGEPress Publications, Pavia, Italy
                2420-8124
                07 August 2013
                18 April 2013
                : 1
                : 2
                : e26
                Affiliations
                [1 ]Department of Health Sciences, School of Public Health, University of Genoa , Italy
                [2 ]Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa , Italy
                Author notes
                Department of Health Sciences, School of Public Health, University of Genoa, via Pastore 1, 16132 Genoa, Italy. +39.010.3537664 - +39.010.3537669 robertobragazzi@ 123456gmail.com

                Conflict of interests: the authors report no conflict of interests.

                Article
                10.4081/hpr.2013.e26
                4768585
                26973911
                a59b8931-db2a-4bb9-aab1-7ad1caed713a
                ©Copyright N. Luigi Bragazzi and G. Del Puente

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 December 2012
                : 04 February 2013
                : 04 February 2013
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 89, Pages: 6
                Categories
                Review

                chronic kidney disease,religiosity,spirituality,spiritual well-being

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