How can you decide about stopping dialysis?

What should you know about stopping dialysis?

Dialysis is a process that filters waste from your blood when your kidneys can no longer do the job. When you have kidney failure, you may have either hemodialysis or peritoneal dialysis.

If you decide to stop dialysis, health professionals can help you have the highest quality of life possible. These are people who give end-of-life care. This may be done through hospice palliative care. Hospice palliative care offers the chance to think about personal goals. It can relieve pain. And it can help take care of your emotional and spiritual needs.

No matter what you decide, take the time to let others know your wishes about your care. You can use an advance care plan to make sure that you get the medical treatment you want.

What are key points about this decision?

• You may feel better on dialysis than you did before you started treatment. But you may have side effects, such as fatigue or muscle cramps. Or you may start to have other problems. If this is the case, you may feel that continuing treatment is too hard.
• If dialysis lets you do the activities you enjoyed before, you may feel that it hasn't changed your daily life that much. You may feel this way even if you can't do all of your old activities. Or you may feel that your quality of life on dialysis is not good.
• Your diagnosis of kidney failure may force you to rethink your goals for your future. If you feel that your life has been rewarding and that you have met many goals, you may feel okay about stopping dialysis. But if you have goals you have not yet met, you may want to continue.
• Most people die within weeks of stopping dialysis. If you choose to stop, you should be ready to put your personal, financial, and legal affairs in order. You may want to continue dialysis if you aren't ready to face these issues.
• Clearly state your wishes to your family. If you decide to stop treatment, will your family understand your reasons? Do they support your decision to continue (or stop) treatment?

Why might you choose to stop dialysis?

If you have been getting regular dialysis, and if a kidney transplant is not an option for you, stopping dialysis may:

• Give you more time each day to spend with friends and family instead of going to treatments.
• Allow you to have more food and drink choices in the time you have left. You may welcome this if your diet has been limited while you have been on dialysis.
• Reduce problems that come with regular dialysis. These problems may include infection or clotting of the access.
• Encourage you to talk with your loved ones about end-of-life goals and wishes.

Why might you choose to stay on dialysis?

Staying on dialysis may:

• Allow you to live longer and have more time with your family and friends.
• Give you time to complete your goals and projects.
• Help you feel better for as long as possible. You may feel better physically on dialysis than you did before dialysis.
• Allow you to do your normal activities.
• Give you more time to put your affairs in order.

Your decision

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.