Withdrawal from dialysis: a palliative care perspective

A retrospective chart review was conducted in this pilot study of 35 patients who withdrew from dialysis and were followed by a palliative care team. Data included etiology of end-stage renal disease, comorbid illnesses, mode of dialysis and duration, survival time after withdrawal, reason for withd...

Full description

Saved in:
Bibliographic Details
Published inClinical nephrology Vol. 66; no. 5; p. 364
Main Authors Chater, S, Davison, S N, Germain, M J, Cohen, L M
Format Journal Article
LanguageEnglish
Published Germany 01.11.2006
Subjects
Adult
Aged
Aged, 80 and over
Euthanasia, Passive
Female
Humans
Kidney Failure, Chronic - therapy
Male
Middle Aged
Palliative Care
Pilot Projects
Renal Dialysis
Retrospective Studies
Survival Analysis
Online AccessGet more information

Cover

More Information
Summary:A retrospective chart review was conducted in this pilot study of 35 patients who withdrew from dialysis and were followed by a palliative care team. Data included etiology of end-stage renal disease, comorbid illnesses, mode of dialysis and duration, survival time after withdrawal, reason for withdrawal, mental competency, symptom management, and the nature of death. Mean survival time was 10 days. The most frequent symptoms following withdrawal were confusion, agitation, pain and dyspnea. 1/3 of the sample were cognitively impaired at the time of the withdrawal decision. 17% experienced suffering during the withdrawal period, 24% had unrelieved symptoms, 19% psychological distress, while just over 1/3 of patients died alone. With the provision of palliative care, symptom prevalence in the last 24 hours dropped from 53 to 20% for pain, 68 to 33% for agitation and 46 to 26% for dyspnea. Opioids and benzodiazepines were used in the treatment of over 90% of patients. Palliative medicine has the potential to improve the care of patients who discontinue dialysis.
ISSN:0301-0430
DOI:10.5414/cnp66364