I'm in my 80s. I've been on kidney dialysis for a year. I'm not a good candidate for a kidney transplant, and dialysis no longer seems to be working. Is it time to consider stopping dialysis?
Answer From Fouad Chebib. M.D.
You have the right to stop treatment, but it's important to discuss the decision carefully with loved ones as well as your care team.
To see how well kidney dialysis is working, your care team can check your weight and blood pressure before and after each session. Regular blood tests, such as those measuring blood urea nitrogen and creatinine levels, and other specialized evaluations also help assess the effectiveness of treatment.
If your dialysis care team doesn't periodically review your overall situation, ask for a review. These periodic reviews are called care team meetings. At a care team meeting, you, your family or other caregivers can offer input and help your team understand how well treatment is working.
Dialysis requires a time commitment. Activities must be scheduled around the dialysis sessions. Dialysis can leave some people feeling "washed out." Worsening health, depression and complications of dialysis may affect how you feel about continuing treatment.
If you're frustrated with a specific aspect of your treatment or another medical problem, talk with your care team. Changes to your treatment plan may improve your situation.
But you may reach a point when you feel you want to stop kidney dialysis. Before stopping, your care team may recommend talking with a counselor or other mental health professional. This can help you make sure that the decision to stop isn't driven by emotional factors or depression, which can be treated.
Dec. 10, 2021
- Koncicki HM, et al. Kidney palliative care: Withdrawal of dialysis. https://www.uptodate.com/contents/search. Accessed Nov. 8, 2021.
- Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis. Accessed Nov. 8, 2021.
- Dialysis: Deciding to stop. National Kidney Foundation. https://www.kidney.org/atoz/content/dialysisstop. Accessed Nov. 8, 2021.
- Feehally J, et al., eds. Approach to renal replacement therapy. In: Comprehensive Clinical Nephrology. 6th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Nov. 8, 2021.