Failure of advance care planning to elicit patients' preferences for withdrawal from dialysis.

摘要: Although withdrawal from dialysis is relatively common among patients, little known about the patients' consideration of during advance care planning. We studied a stratified random sample 400 hemodialysis patients in two geographic areas (all six units within 75 miles Morgantown, WV, and all nine Rochester, NY) by reviewing responses to questionnaire addressing issues Interviews were performed trained interviewers routine treatment. Fifty-one percent had completed an directive (29% living will health proxy, 22% or proxy). Patients who directives more likely have notified their decision makers roles (91% with 81% proxy v 55% no directive; P < 0.01). Most not discussed wishes for specific interventions event permanent coma: 41% mechanical ventilation; 35%, tube feedings; 25%, cardiopulmonary resuscitation; only 18% stopping dialysis. most end-of-life care, but was least often intervention, even this patient subset. Sixty-nine 55%, 43%, 31% 0.001). common, it rarely planning patients. Dialysis unit staff nephrologists should address involving chronic