Integration of Nephrology and Palliative Care: A Bibliometric Analysis with Visual Mapping of the 50 Most Cited Publications

Abstract

Introduction: The incidence of chronic kidney disease (CKD) is increasing, particularly in countries with low socioeconomic indicators, where the consequences are more complex. Given the significant burden of symptoms, comorbidities, and mortality associated with CKD, the principles of palliative care are important in clinical practice. Objective: This manuscript aims to analyze the intersection of nephrology and palliative care publications through a bibliometric analysis. Methods: In April 2024, the 50 most cited articles were extracted from the SCOPUS (Elsevier) database. The variables obtained were: number of citations, journal of publication, and its 5-year impact factor, country of the correspondent author, year of publication, guiding theme of the articles, and research methods. Data were also analysed in the VOSviewer software to produce the visual mapping. Results: The articles were published in 18 different journals from 2000 to 2021, with a mean number of citations per article of 70.78. Clinical Journal of the American Society of Nephrology was the journal with the highest number of citations (1673) and articles (15). The United States of America was the most prolific country with 28 articles and 1749 citations. There were no articles from lower-middle-income or low-income countries. “Symptom control or prevalence” is the most cited theme in this area (864), and “decision making about renal substitutive therapy” is the most researched one (15 articles). 33 publications were from primary research and 17 from secondary research, represented exclusively by narrative reviews. Conclusion: The integration of palliative care in nephrology remains an emerging and developing field, primarily centered in high-income countries, particularly the USA, with no representation of low-income countries. Most articles are based on primary research and are more commonly published in nephrology journals, with “symptom control or prevalence” and “decision making about renal substitutive therapy” as their main themes.