| Theme |
Trends of Chronic Dialysis and Kidney Transplantation in the World |
| Title |
Current issues on dialysis discontinuation in the U. S. |
| Author |
Yukie Kurihara |
Division of Palliative Medicine, Shizuoka Cancer Center |
| [ Summary ] |
There is an increasing number of patients who are on long-term dialysis and / or frail elderly with multiple comorbidities, who suffer from various symptoms as well as the physical burdens of dialysis. Such significant physical distress is recognized as one of the main reasons for those patients choosing to discontinue dialysis. Dialysis discontinuation / withdrawal may be perceived as a “patient's option ” in the U.S. but open communication with the patients / families on this topic is not easy. The palliative care approach has gradually been expanded to include the field of chronic kidney disease (CKD). Newly developed guidelines include CKD specific symptom management skills, communication issues regarding the decision making process for dialysis withdrawal, and bereavement care. |