{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T09:12:10Z","timestamp":1778231530126,"version":"3.51.4"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Helsinki University Hospital Comprehensive Cancer Centre"},{"DOI":"10.13039\/501100010711","name":"Cancer Foundation Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite the heavy symptom burden and progressive nature of non-malignant kidney diseases, access to palliative care services may be limited. We evaluated access to specialist palliative care (SPC), and its effect on health care utilization among patients with non-malignant and malignant kidney disease during their final year of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study examined causes of death among \u226518-year-old individuals in Finland in 2019 using the National Causes of Death Register. Data on access to SPC, emergency department contacts, and hospitalizations were collected from the National Care Register for the final year of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five hundred eighty-five patients had non-malignant kidney disease (54.8% females, mean age 84 years at the time of death) and 706 patients had malignant kidney disease (35.3%, 77.2 years, respectively). Of the patients with non-malignant kidney disease, only 54 (9.1%) had access to SPC services compared to 195 (27.6%) with malignant kidney disease (P\u00a0&amp;lt;\u00a0.001). Within patients with malignant kidney disease, those who had access to SPC died at home more often (10.6% vs. 5.9%; P\u00a0=\u00a0.049), had fewer emergency department contacts (19.7% vs. 32.9%), and had a lower proportion of hospitalizations (16.4% vs. 37.2%; P\u00a0&amp;lt;\u00a0.001) and readmissions to secondary care (4.6% vs. 10.6%; P\u00a0=\u00a0.025) when compared to those without SPC access. No difference with regard to SPC access was seen among patients with non-malignant kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While SPC demonstrated benefits in malignant kidney disease patients\u2019 health care utilization, access was markedly limited for patients with non-malignant conditions, underscoring the need for improvements in service provision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag111","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:42:09Z","timestamp":1775648529000},"source":"Crossref","is-referenced-by-count":0,"title":["Access to specialist palliative care and health care service utilization during the final year of life among patients with kidney disease"],"prefix":"10.1093","volume":"19","author":[{"given":"Hanna-Riikka","family":"Lehto","sequence":"first","affiliation":[{"name":"Division of Palliative Medicine, University of Turku Department of General Medicine, , Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarit","family":"Wuorela","sequence":"additional","affiliation":[{"name":"Turku University Hospital and the Wellbeing Services County of Southwest Department of Medicine\/Division of Nephrology, , Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satu","family":"Ahtiluoto","sequence":"additional","affiliation":[{"name":"Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko","family":"Nuutinen","sequence":"additional","affiliation":[{"name":"Nordic Healthcare Group , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiina","family":"Saarto","sequence":"additional","affiliation":[{"name":"Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0117-8559","authenticated-orcid":false,"given":"Timo","family":"Carp\u00e9n","sequence":"additional","affiliation":[{"name":"Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Outi","family":"Akr\u00e9n","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, University of Turku Department of General Medicine, , Turku ,","place":["Finland"]},{"name":"Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"2026050804512626500_bib1","doi-asserted-by":"publisher","first-page":"3519","DOI":"10.1186\/s12889-024-21065-9","article-title":"Epidemiological shifts in chronic kidney disease: a 30-year global and regional assessment","volume":"24","author":"Qin","year":"2024","journal-title":"BMC Public Health"},{"key":"2026050804512626500_bib2","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/S0140-6736(13)60687-X","article-title":"Chronic kidney disease: global dimension and perspectives","volume":"382","author":"Jha","year":"2013","journal-title":"Lancet"},{"key":"2026050804512626500_bib3","article-title":"The burden of diseases, injuries, and risk factors by state in the USA, 1990-2021: a systematic analysis for the Global","author":"Mokdad","year":"2024"},{"key":"2026050804512626500_bib4","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016\u201340 for 195 countries and territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet"},{"key":"2026050804512626500_bib5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1093\/ndt\/gfm446","article-title":"How does early chronic kidney disease progress? 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