Death from Dialysis Termination

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25 Citations (Scopus)

Abstract

The only detailed analysis of dialysis termination by viable patients was reported by Neu and Kjellstrand (N Engl J Med1986; 314: 14–20) from the USA. We analysed a similar series from Halifax, Nova Scotia, to add to our understanding of this important mode of treatment rejection by dialysis patients. Of 178 chronic dialysis patients at risk from January 1982 to May 1987, 11 viable patients (6%) stopped dialysis (16% of all patient deaths) after a mean of 22±7 months of therapy. Mean age at death was 67±5 years. The majority of these patients were receiving in-centre haemodialysis. Six patients independently decided to stop therapy, while in three cases physicians first proposed termination. In only two cases did the family propose termination. All patients died in hospital a mean of 10±2 days after the last dialysis. Dementia was the reason for stopping treatment in only two cases, while chronic heart failure with poor exercise tolerance was the major precipitant. One patient suffered from diabetes mellitus. We were not able to differentiate patients terminating therapy from those continuing treatment on the basis of age or co-morbidity, suggesting that subjective patient perception of their condition is a critical factor in stopping dialysis.

Original languageEnglish
Pages (from-to)41-44
Number of pages4
JournalNephrology Dialysis Transplantation
Volume4
Issue number1
DOIs
Publication statusPublished - 1989

ASJC Scopus Subject Areas

  • Nephrology
  • Transplantation

PubMed: MeSH publication types

  • Journal Article

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