My 82-year-old husband has been on kidney dialysis for a year. He's not a good candidate for a kidney transplant. How will we know when dialysis is no longer working and should be discontinued?
Answer From Robert Albright, D.O.
To determine how well kidney dialysis is working, your husband's doctor can check his weight and blood pressure before and after each session. Regular blood tests, such as those measuring urea and creatinine levels, and other specialized evaluations also help assess the effectiveness of the treatment.
If your husband's dialysis care team doesn't periodically review his overall situation, ask for a review. These periodic reviews — called care team meetings — include input from your husband and you and help the care team understand how well treatment is working.
Kidney dialysis is only part of your husband's treatment. He must also adjust to fluid and dietary restrictions and take medications. In addition, dialysis affects his time and schedule. Activities must be scheduled around the treatments. Dialysis may leave your husband feeling "washed out." Worsening health, depression and complications of dialysis may affect how your husband feels about continuing treatment.
If your husband is frustrated with a specific aspect of his treatment or another medical problem, talk with his doctor. His doctor may be able to make some changes to the treatment plan that could improve his situation.
There may come a time when your husband feels he wants to stop kidney dialysis. Before stopping, your husband's care team may recommend talking with a counselor or other mental health professional to make sure that the decision to stop isn't driven by emotional factors or depression, which can be treated.
Your husband has the right to discontinue treatment, but it's important to discuss the decision carefully with loved ones as well as your husband's care team.
Dec. 10, 2019
Robert Albright, D.O.
See more Expert Answers
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- Davison SN, et al. Withdrawal of dialysis: Decision making #207. Journal of Palliative Medicine. 2012;15:1270.
- Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-topics/kidney-disease/hemodialysis/Pages/facts.aspx. Accessed Oct. 26, 2016.
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