Patients with Chronic Kidney Disease who elect dialysis generally experience progressive functional decline over months to years, punctuated by episodes of life-threatening complications. Elderly or chronically ill patients with co-morbid diseases, at the initiation of dialysis, can be expected to have greater complications and a shorter survival. Poor prognostic factors such as older age, low serum albumin, poor functional status, and co-morbid illnesses such as diabetes and cardiovascular disease can be used to estimate prognosis. Anuric patients, who elect to not initiate or discontinue dialysis, typically survive for 7-14 days. The prognosis is longer for patients with residual renal function who continue to make urine. Here are a few references to help with the decision making:
- Clinical Practice Guideline on Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis
- Which patients choose to stop Dialysis
- What happens if someone stops Dialysis
- The role of Palliative Medicine in the Initiation and Withdrawal from Dialysis
- Understanding and communicating prognosis
- Death by Withdrawal From Dialysis
It is a difficult decision. Our hope is that we were able to help you in making the decision process easier.