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A Nephmadness Special by Drs. Holly  M. Koncicki and Kenar D. Jhaveri (AJKD Blog Editor) from the Division of Kidney Diseases and Hypertension, Hofstra Northwell School of Medicine, NY.

ACROSS:

1. _________ status has been shown to decline in elderly patients following the initiation of dialysis.

3. The syndrome of _________ is two times higher in chronic kidney disease (CKD) patients over the age of 65 as compared to age-matched controls with normal renal function and is a marker of increased mortality at one year in dialysis patients.

6. For management of chronic pain in end stage kidney disease (ESKD) patients, _________ is a preferred opioid and can be administered transdermally.

10. Approximately 40% of ESKD patients have been estimated to suffer from moderate to severe _________.

11. _________ tell ask is a communication tool that can be used to assess a patient’s understanding of his/her current medical condition.

12. Dialysis _________ has increased over recent years, and is estimated to precede death in up to 25% of ESKD patients.

13. Patients over the age of _________ have been the fastest growing group of dialysis patients, though recently rates have declined.

14. _________ is a common psychiatric illness that has been estimate to affect up to 40% of dialysis patients.

DOWN:

2. It is unclear if dialysis offers a survival benefit as compared to conservative treatment in elderly patients with high _________ scores or heart disease.

4. When uncertainty exists as to how a patient will do on dialysis a _________ should be recommended that is time-limited with pre-defined patient goals.

5. An approach to shared decision making involves reviewing medical indications, patient _________, quality of life, and contextual features.

7. Currently undergoing evaluation in clinical trials, _________ is an opioid receptor modulator that has been shown useful in treatment of refractory uremic pruritis.

8. Despite providing excellent end of life care, a minority of ESKD patients utilize _________ even among those who withdraw from dialysis.

9. _________ has been used to treat numerous symptoms including neuropathic pain, pruritis, and restless leg syndrome in ESKD patients.

13. It is estimated that the largest group of patients with CKD are those over the age of _________.

Please click here for the crossword answers.

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