Terminal medical care and blood purification

Abstract

This study elucidates the relationship between terminal medical care and end-stage renal disease care. When dialysis becomes necessary, terminal medical care is required in the field of kidney disease. This is because if dialysis is not initiated promptly when needed, a life-threatening situation can occur. The recently introduced conservative kidney management (CKM), which does not include renal replacement therapy, has been gaining acceptance as a treatment option for end-stage renal failure, particularly in North America and Western European countries. This article introduces CKM, with a focus on its history, definition, and comparison of its implementation across different countries, and provides a literature-based evaluation of CKM in Japan. Decision making through a multidisciplinary medical team is essential in Japan. Additionally, to facilitate its acceptance, it is imperative to establish an environment that includes guidelines and laws related to end-of-life medical care and to engage in discussions surrounding these issues.