Maria Da Silva-Gane

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BACKGROUND Health-related quality of life (QOL) is an important outcome for older people who are often on dialysis for life. Little is, however, known about differences in QOL on haemodialysis (HD) and peritoneal dialysis (PD) in older age groups. Randomising patients to either modality to assess outcomes is not feasible. METHODS In this cross-sectional,(More)
OBJECTIVES To study factors influencing the recommendation for palliative (non-dialytic) treatment in patients approaching end-stage renal failure and to study the subsequent outcome in patients choosing not to dialyse. DESIGN Cohort study of patients approaching end-stage renal failure who underwent multidisciplinary assessment and counselling about(More)
BACKGROUND Elderly patients with end-stage renal disease and severe extra-renal comorbidity have a poor prognosis on renal replacement therapy (RRT) and may opt to be managed conservatively (CM). Information on the survival of patients on this mode of therapy is limited. METHODS We studied survival in a large cohort of CM patients in comparison to(More)
Depression is the most common psychopathological condition among patients with end-stage renal disease (ESRD), yet it is still under-recognized and misdiagnosed. Depression reduces quality of life and has a negative clinical impact upon sufferers with chronic illness, including ESRD. This article discusses the negative effects of depression among the ESRD(More)
PURPOSE OF REVIEW Elderly patients comprise the fastest growing population initiating dialysis and also experience the worst outcomes, including increased mortality, loss of functional status, and impaired quality of life. Nephrologists are often challenged with how best to engage in dialysis decision-making discussions within this population.(More)
BACKGROUND Not all patients are suitable for kidney transplantation; however, little is known about the views and attitudes of patients who are not on the waiting list for transplantation. OBJECTIVE This study aimed to determine the views and attitudes of patients who are not on the waiting list regarding the process of transplant allocation. METHODS A(More)
BACKGROUND AND OBJECTIVES Depression is common in patients on hemodialysis, but data on the benefits and risks of antidepressants in this setting are limited. We conducted a multicenter, randomized, double-blind, placebo-controlled trial of sertraline over 6 months in patients on hemodialysis with depression to determine study feasibility, safety, and(More)
Treatment with dialysis has benefitted large numbers of patients with advanced kidney disease. It is though highly intrusive and demanding and some elderly, frail patients may tolerate it poorly. Some of these patients who are either approaching 'end-stage' kidney disease or 'failing' despite being on dialysis may choose to pursue supportive or palliative(More)
AIM In elderly, dependent patients with advanced chronic kidney disease, dialysis may confer only a small survival advantage over conservative kidney management (CKM). We investigated the role of rate of decline of kidney function on treatment choices and survival. METHODS We identified a retrospective (1995-2010) cohort of patients aged over 75 years,(More)
BACKGROUND Depression is common in haemodialysis (HD) patients and associated with poor outcomes. PURPOSE To evaluate whether depression symptoms predict survival and transplantation in a large sample of haemodialysis patients using cause-specific survival models. METHODS Survival data was collected between April 2013 and November 2015, as part of the(More)