Dialysis discontinuation: quo vadis?

Adv Chronic Kidney Dis. 2007 Oct;14(4):379-401. doi: 10.1053/j.ackd.2007.07.008.


Approximately 1 in 4 deaths of patients maintained on dialysis in the United States is preceded by a decision to discontinue treatment. Once considered to be a form of suicide, dialysis discontinuation is now increasingly common in most countries that are fortunate enough to offer renal replacement therapies. Given an aging and progressively sicker chronic kidney disease patient population, the rate of terminating dialysis is likely to increase. The literature on dialysis discontinuation includes studies principally from Canada, the United Kingdom, and the United States. The research is reviewed, critiqued, and examined to determine its relevance to practice. Future issues include the need to explore variability in dialysis practice as well as employment of a more patient-centered approach that is consistent with modern palliative medicine.

Publication types

  • Review

MeSH terms

  • Humans
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / therapy*
  • Palliative Care / statistics & numerical data
  • Palliative Care / trends*
  • Patient-Centered Care
  • Renal Dialysis / mortality*
  • Withholding Treatment / statistics & numerical data
  • Withholding Treatment / trends*