When Is It Time to Stop Kidney Dialysis Treatment?

What Is Kidney Dialysis?

Kidney dialysis treatment is a life-saving procedure that is used to remove waste and excess fluid from the blood when the kidneys are no longer able to perform this function. It is a common treatment, with nearly 750,000 people in the United States alone on dialysis. While dialysis can be an effective treatment for kidney failure, it is not a cure, and there may come a time when it is appropriate to stop dialysis treatment. In this blog, we will explore when it is time to stop kidney dialysis treatment and what factors should be considered when making this decision.

Who Needs Dialysis?

Dialysis is a treatment option for patients with severe kidney disease. Prior to reaching this point, there are several medications and lifestyle changes that a patient can make to improve their kidney function. These include controlling their blood sugar levels and blood pressure, limiting salt and sugar intake, and finally exercising on a regular basis. Dialysis is not an easy treatment, and this should be reiterated to patients whose kidney function has begun to deteriorate. Taking care of their health can prevent them from reaching the point where dialysis is necessary, which should be the ultimate goal. In the event that dialysis is a necessary treatment, at Cassena Kidney Care we are up to the challenge of getting you back to feeling better.

How Does Dialysis Work?

Dialysis is a complicated treatment that you will attend 3 times weekly. At the visit, you will have two lines placed into each arm. One arm will extract the blood from your body and carry it to the dialysis machine. This machine then uses a filtrate to remove the waste that has built up in your body and then will return the newly filtered blood back to your body. This entire process may take anywhere from 4-8 hours and is dependent on a variety of factors. Once you have reached a point of dialysis, the only definitive treatment that remains after it is a kidney transplant. For patients with severe kidney disease on dialysis, the process is a necessary one to preserve their life. Therefore, the decision to stop kidney dialysis treatment is a complicated one that requires careful consideration by the patient, their family, and their healthcare team. In general, there are two main reasons why a patient may consider stopping dialysis: quality of life and end-of-life care.

Quality Of Life

For many patients with end-stage kidney disease, dialysis can be a burdensome and time-consuming treatment that can negatively impact their quality of life. Dialysis requires frequent visits to a dialysis center, which can be a significant time commitment for patients and their families. Additionally, the treatment itself can cause discomfort and side effects, such as fatigue, muscle cramps, and low blood pressure. Over time, these side effects can become more severe and may limit a patient’s ability to perform everyday activities, such as working or spending time with family and friends.

When considering whether to stop dialysis for quality of life reasons, patients and their families should discuss their concerns with their healthcare team. This may include a nephrologist, who specializes in kidney disease, a palliative care specialist, who focuses on relieving symptoms and improving quality of life, and a social worker, who can help address practical and emotional concerns.

End-Of-Life Care

Another reason why a patient may consider stopping dialysis is when they are nearing the end of their life. Dialysis may not be an appropriate treatment for patients with advanced age, significant comorbidities, or terminal illnesses. In these cases, stopping dialysis may allow the patient to spend their remaining time with their family and loved ones in a more comfortable and peaceful environment.

When considering stopping dialysis for end-of-life care reasons, patients and their families should discuss their wishes with their healthcare team. This may include discussing the goals of care, such as symptom management and comfort, and whether hospice or palliative care may be appropriate.

Factors To Consider

When making the decision to stop dialysis, patients and their families should consider a range of factors, including the patient’s overall health, their goals of care, and their personal preferences. Some of the key factors to consider include:

Age:

Older patients may be more likely to experience complications from dialysis and may have a shorter life expectancy, making them less likely to benefit from continuing the treatment.

Comorbidities:

Patients with multiple chronic conditions, such as heart disease or diabetes, may experience more severe side effects from dialysis and may be at higher risk for complications.

Prognosis:

Patients with a poor prognosis, such as those with terminal illnesses or advanced age, may not benefit from continuing dialysis treatment.

Functional status:

Patients with severe functional limitations, such as difficulty with mobility or activities of daily living, may find it difficult to continue with dialysis treatment.

Goals of care:

Patients and their families should discuss their goals of care with their healthcare team to determine whether continuing dialysis aligns with their wishes and values.

Personal preferences:

Patients and their families should also consider their personal preferences, such as their desire to spend time with loved ones, pursue hobbies, or travel.

In conclusion, the decision to stop kidney dialysis treatment is a complex one that requires careful consideration by the patient, their family, and their healthcare team. While dialysis can be an effective treatment for kidney failure, it is not a cure. This is important to keep in mind when weighing the benefits, risks, and alternatives of continuing the treatment.

Who Should I Contact If I Have More Questions?

If you finish reading this blog and are left with questions, we can help. At Cassena Kidney Care, we are leaders in the treatment of kidney disease. Our dedicated team of professionals and providers will ensure that you have all of your questions answered and do not go through this process alone. Further, we will design a treatment plan that focuses on you, the patient, and your goals. Please contact us for further information, and we look forward to taking care of you!