When to Stop Dialysis in ESRD? Families Weigh In

Families of patients with end-stage renal disease (ESRD) tended to be more satisfied with end-of-life care when dialysis was discontinued before death, but many may not know this is an option, researchers said.
Compared with the families of patients who continued with dialysis, the families of those who stopped the treatment before death were modestly more likely to rate end-of-life care as excellent -- 54.9% versus 45.9% -- for a risk difference of 9.o percentage points (95% CI 3.3-14.8), Claire Richards, PhD, RN, of the Veterans Affairs health system in Seattle, and colleagues reported online in JAMA Network Open.
However, for patients who continued with dialysis, families more often rated end-of-life care as excellent when hospice services were provided (60.5% vs 40.0%; risk difference 20.5 points, 95% CI 12.2-28.9), Richards's group noted.
Previous studies indicated that clinicians tend to present intensive treatments as the default option required to prolong life, Richard and co-authors said, instead of discussing transition to comfort-oriented care.--> READ MORE