Deny dialysis

Different names, same great care Fresenius Kidney Care dialysis centers are part of Fresenius Medical Care North America (FMCNA). Some centers may be known as Fresenius Kidney Care or Fresenius Medical Care, as well as other names. Every center listed in our dialysis finder results is part of the Fresenius Kidney Care dialysis network.

The prevalence of end-stage renal disease continues to increase, and dialysis is offered to older and more medically complex patients. Pain is problematic in up to one-half of patients receiving dialysis and may result from renal and nonrenal etiologies. Opioids can be prescribed safely, but the patient's renal function must be considered when selecting a drug and when determining the dosage. Fentanyl and methadone are considered the safest opioids for use in patients with end-stage renal disease. Nonpain symptoms are common and affect quality of life. Phosphate binders, ondansetron, and naltrexone can be helpful for pruritus. Fatigue can be managed with treatment of anemia and optimization of dialysis, but persistent fatigue should prompt screening for depression. Ondansetron, metoclopramide, and haloperidol are effective for uremia-associated nausea. Nondialytic management may be preferable to dialysis initiation in older patients and in those with additional life-limiting illnesses, and may not significantly decrease life expectancy. Delaying dialysis initiation is also an option. Patients with end-stage renal disease should have advance directives, including documentation of situations in which they would no longer want dialysis. The number of patients with end-stage renal disease is increasing in the United States, in part because of the epidemic of diabetes mellitus. Dialysis is now offered to older and more medically complex patients who would not have been consider...

For many people with The decision to stop treatment should be an informed and voluntary choice. Experts recommend patients talk with their physicians and a social worker or therapist to understand their choices and know what to expect. Talking to family members about stopping dialysis It’s the patient’s right to make the decision to stop dialysis. Sometimes, knowing that death can be pain-free and peaceful for the person with ESRD helps ease family members’ fears. There are many reasons why someone with ESRD may not want to continue or start dialysis. Some people feel they’ve lived a full life and don’t want to bother with additional surgery and treatments. Studies have shown that people most likely to withdraw from dialysis are older and living in nursing homes. They often have health problems in addition to kidney disease, and suffer more severe pain. They usually have physical limitations that restrict normal daily activities. If a loved one decides to stop dialysis, it’s important that family members try to understand and respect that decision. The patient’s treatment team should be available to make sure the patient and family members understand the effects of the decision. Preparing for stopping dialysis—advance directives and hospice While talking about death and dying can be difficult, most families find it’s a relief to have a plan in place for when the time comes. Planning for care and respecting the wishes of the patient makes end-of-life decisions easier. An ad...

Background and Aims Kidney transplantation is considered the best renal replacement therapy (RRT) for patients with end-stage renal disease, nevertheless, some dialysis patients refuse to be transplanted. Many patients are concerned about their quality of life as a patient on dialysis compared to life with a new, functioning kidney. The results from many studies have shown that patients who have been living with a transplanted kidney for 10 years demonstrate a greater likelihood of still being alive than those on dialysis. For every 10 patients receiving a new kidney, eight will still have that kidney working three years after the operation. So, considering survival alone, individuals receiving a new kidney do better than those on dialysis. But not all the CKD and CKD on HD share the same opinion and a number refuse kidney transplantation. The aim of this paper is to identify the reasons for choosing or refusing kidney transplantation as renal replacement therapy among patient with Chronic Kidney Disease (CKD). Method We used purposeful sampling because it was more relevant to identify and to select the individuals who seemed in-keeping with the social facts we wanted to study. We wanted to retrace participants’ paths of care to identify the reasons for their choice. Patients who were treated using hemodialysis as well as those who opted for peritoneal dialysis were interviewed. We also interviewed health professionals (doctors, nurses, a psychologist) for their opinions o...