Abstract:
:Nephrologists offer renal replacement therapy (RRT) to patients who are unlikely to benefit in part because of our discomfort discussing goals of care in the setting of an uncertain prognosis for a given individual. Permanent neurological impairment, terminal illness (life expectancy <6 months), medical conditions precluding the safe delivery of dialysis, elderly patients with poor prognosis, and those who begin "early" RRT are categories of patients for whom dialysis may not be beneficial. Successful use of time-limited trials of dialysis may reduce the number of patients who are started on RRT without significant benefit. However, clear achievable milestones and goals need to be incorporated into plans for time-limited trials to ensure that continuing RRT beyond the trial period is appropriate. The lack of information on outcomes and symptom management using a "palliative approach" to dialysis suggests this should not be a clinical option until additional study is done and efficacy data available. Clinical practice guidelines are available to assist nephrologists in the appropriate withholding of RRT.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Holley JLdoi
10.1111/sdi.12492subject
Has Abstractpub_date
2016-07-01 00:00:00pages
306-8issue
4eissn
0894-0959issn
1525-139Xjournal_volume
29pub_type
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
pub_type: 杂志文章
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更新日期:2000-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 社论
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更新日期:2009-09-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 社论
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更新日期:2011-09-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2019-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2018-05-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/sdi.12732
更新日期:2019-01-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2009.00600.x
更新日期:2009-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00300.x
更新日期:2007-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章
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更新日期:2009-05-01 00:00:00
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更新日期:2016-07-01 00:00:00
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journal_title:Seminars in dialysis
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更新日期:2014-05-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 社论
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更新日期:2002-09-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2020-12-09 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00482.x
更新日期:2008-09-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2010-03-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2004-05-01 00:00:00
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journal_title:Seminars in dialysis
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更新日期:2004-11-01 00:00:00