{"title":"Palliative Dialysis","authors":"Vanessa Grubbs","doi":"10.1093/med/9780190945527.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780190945527.003.0021","url":null,"abstract":"Dialysis is typically thought of as a life-saving treatment for patients with end-stage kidney disease (ESKD), but for a subset of older patients with dementia or ischemic heart disease or other advanced comorbidities it may not confer a survival benefit, stop the ESKD trajectory, and be life-extending despite achieving standard quality metrics. Providers should consider palliative dialysis for patients with ESKD who have a life expectancy of less than one 1 year, symptoms that might be ameliorated by dialysis, and values such that they would consider a trial of dialysis. Offering palliative dialysis should be considered part of a patient-centered approach for some patients with ESKD with a poor prognosis even with dialysis. In this broadened view of choices for patients with ESKD, decision-making need not only include forgoing or withdrawing dialysis as options. Dialysis is a care plan that strives to achieve hopes while minimizing fears. This balance of the positives and negatives of dialysis can be thought of as palliative dialysis.","PeriodicalId":343960,"journal":{"name":"Palliative Care in Nephrology","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133033873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}