Read by QxMD icon Read

Meeting the guidelines for end-of-life care

Gillian Brunier, David M J Naimark, Michelle A Hladunewich
Advances in Peritoneal Dialysis 2006, 22: 175-9
The number of patients initiating dialysis in most countries continues to increase, with the greatest increase being in the oldest age group. Clinical practice guidelines have been developed to help the nephrology team with end-of-life carefor patients on dialysis. The aim of the project reported here was to assess if we were meeting the guidelines. We conducted a retrospective cohort study of all patients 80 years of age and older who had started dialysis at our center Our cohort included 105 patients (50% men; median age: 84.5 years; age range: 80-95 years), of whom 55% were on hemodialysis and 45% were on peritoneal dialysis (PD). Overall life expectancy was 2.1 years. Among the 59 patients who died while still part of our program, 92% had a do not resuscitate order in place, and 46% had withdrawn from dialysis. Palliative care was consulted in 46% of cases. Dyspnea and pain were the two most common symptoms in the last 24 hours of life. Of these 59 patients, 71% died in hospital. Only 6 patients died at home, all of these being on home PD. End-of-life care for this elderly cohort of dialysis patients could be improved on several measures to meet clinical practice guidelines, especially with greater access to palliative care units and community palliative care programs.


You need to log in or sign up for an account to be able to comment.

No comments yet, be the first to post one!

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"