Ontario Renal Network | Reseau Renal de L'Ontario

Palliative Care


The Ontario Renal Network Palliative Care Report:
Recommendations towards an approach
for chronic kidney disease

Woman speaking to senior on park bench

The Ontario Renal Network is proud to release the Palliative Care Report which aims to strengthen our efforts in palliative care and focuses on people living with chronic kidney disease. boxes
Margaret L
“No one ever spoke to us about what to expect at the end of life.”

Palliative care is an approach to care that aims to relieve suffering and improve the quality of both living and dying. It is a growing topic of interest in healthcare and a priority for Ontario, with the establishment of the Ontario Palliative Care Network (OPCN) to promote the creation of a coordinated, standardized approach for delivering palliative care services in the province.

People with advanced chronic kidney disease (CKD) have challenges that are distinct from those with cancer or other chronic illnesses. They are often elderly with complex medical histories, experience distressing symptoms, and have a high mortality rate (one-year survival rate for Canadians receiving dialysis is 85% (2009), Five-year survival rate is 43% (2006)). To address the unique palliative care needs of people with CKD and their families, the Ontario Renal Network convened a working group with representation from multiple disciplines and specialties, as well as from patients and their families.

The Ontario Renal Network is proud to release the Palliative Care Report which aims to strengthen our efforts in palliative care in alignment with provincial direction, and focuses specifically on people with advanced CKD. It provides a provincial framework that will guide the integration of a palliative approach to care within CKD over the next four years, and offers key recommendations to implement the framework within Regional Renal Programs in Ontario.


  1. Educate providers, patients and families about the benefits of a palliative approach to care for people living with CKD to strengthen service capacity and build awareness.
  2. Strengthen system accountability by establishing local clinical champions within nephrology in the Ontario Renal Network Regional Renal Programs to support a palliative approach to care.
  3. Support shared understanding of palliative care needs for CKD patients through common terminology among providers across care settings to facilitate clear communication and terminology that is recognizable to patients and families.
  4. Introduce conversations about advance care planning and goals of care early. Create accountability to support and review these goals with patients regularly through their care journey.
  5. Adopt a standard approach to identify who may benefit from a palliative approach to care, to assess symptoms and to manage care.
  6. Develop key performance indicators to measure progress in the next three years.