Article Text

Download PDFPDF
Dialysis withdrawal: end of life and advanced care plans
  1. Joanna Prentice1,2,
  2. Lucy Hetherington3,
  3. Mark Findlay3 and
  4. Tara Collidge3
  1. 1Renal, Queen Elizabeth University Hospital Campus, Glasgow, UK
  2. 2Institute of Cancer Studies, University of Glasgow, Glasgow, UK
  3. 3The Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital Campus, Glasgow, UK
  1. Correspondence to Dr Joanna Prentice, Renal, Queen Elizabeth University Hospital Campus, Glasgow G51 4TF, UK; joanna.prentice1{at}nhs.net

Statistics from Altmetric.com

Withdrawal of dialysis was the second most common cause of death recorded for renal replacement therapy (RRT) in Scotland in 2017; 23% of all deaths.1 In those ≥75 years, this rises to 28%; withdrawal and cardiovascular disease the equal primary causes.1 With an ageing population and more older patients on RRT, considerations around dialysis withdrawal are of increasing importance.1

There is a mean survival of 7.4 (range, 0–40) days once dialysis is withdrawn.2 Successful advanced care planning (ACP) improves end-of-life care (EOLC), the likelihood of dying in their preferred place of death (PPOD) and reduces psychological impact on the surviving carers.3 The degree to which ACP is initiated in this population is unknown which prompted this work.

We did a retrospective analysis of adults receiving dialysis for end-stage renal disease. They were identified by the electronic patient record (EPR) (Strathclyde Electronic Renal Patient Record (SERPR), Vitalpulse, UK) in combination with the Greater Glasgow and Clyde electronic records (GGCER). Using SERPR, we identified deaths after dialysis withdrawal over 19 months (2015–2017). All data were anonymised. …

View Full Text

Footnotes

  • Twitter @prentice_joanna

  • Contributors JP and TC conceived the idea. JP, LH and TC collected data. LH and JP literature review. MF provided review of paper and all data analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.