| Theme | Geriatric nephrology and dialysis | |
|---|---|---|
| Title | The present circumstances and problems involved in withholding or discontinuing dialysis | |
| Publish Date | 2015/09 | |
| Author | Takashi Harada | Nagasaki Kidney Hospital |
| Author | Rika Eto | Nagasaki Kidney Hospital |
| Author | Hiroko Maruyama | Nagasaki Kidney Hospital |
| Author | Satoshi Funakoshi | Nagasaki Kidney Hospital |
| [ Summary ] | Provision of end-stage medical care for elderly patients on maintenance dialysis has become an important issue. We report on the present circumstances and problems involved in withholding or discontinuing maintenance dialysis. In 2014, the Japanese Society for Dialysis Therapy published an opinion on the decision-making process for beginning or continuing maintenance dialysis. Our hospital began obtaining advance directives from patients and their families in 2008. In 2014, 95 % of patients who died had received end-stage care based on advance directives before their deaths. This resulted in fewer patients requiring ventilator support and more patients discontinuing maintenance dialysis. The mean period from discontinuing dialysis to death was 8.3 days. Provision of palliative care as per patients' wishes requires team effort, and psychological and social support should be given to families during and after end-stage care. |
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