When is Enough, Enough: Pushing the Limits on Kidney Dialysis
This is Rita Rubin, writing in USA Today:
The fastest-growing group of patients starting dialysis in the USA is 75 and older. And the average age at which an American goes on dialysis is now older than 64….
Among patients who begin dialyzing in their 80s and 90s, nearly half are suffering from congestive heart failure and one-third from diabetes or cardiovascular disease. One survey of nephrologists, or kidney doctors, found that nearly half would be willing to continue dialysis in a patient who develops permanent severe dementia.
The study in The Journal of the American Society of Nephrology is gated.
The survey of nephrolologists is amazing.
I think it’s wrong to keep people alive just because the technology exists to do it. On dialysis for patients with dementia, this would not happen in other countries.
Would these same nephrologists vote to withhold insulin from diabetic patients who develop permanent and severe dementia? How about anti-rejection drugs be withheld from transplant patients with permanent and severe dementia? What about cortisol for people with severe dementia and adrenal insufficiency?
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