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Nephrol Dial Transplant (2003) 18: 869-871
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comment

Which patients choose to stop dialysis?

Alan S. Kliger and Fredric O. Finkelstein

Hospital of St Raphael, Renal Research Institute and Yale University, New Haven, CT, USA

Keywords: decision making; depression; discontinuation of dialysis; end of life care; end-stage renal disease; personal beliefs

The first 10% of the full text of this article appears below.

In 1986, Neu and Kjellstrand [1] reported that 22% of all end-stage renal disease (ESRD) deaths in a large regional dialysis programme resulted from discontinuation of dialysis therapy. Since then, several retrospective studies in the US have confirmed this observation. Two separate analyses of the US Renal Data System database in two time periods showed that ~20% of patients who die withdraw from dialysis at some time preceding their death [2,3]. While some nephrologists accept these statistics as consistent with their experience, others are sceptical and claim that they virtually never see . . . [Full Text of this Article]

Incidence and patient characteristics

Do cultural and educational factors play a role?

Changing attitudes toward life-sustaining therapies

Shared decisions among physician, patient and family

Conclusion


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