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doi: 10.1097/NJH.0000000000000862.
Online ahead of print.
Item in Clipboard
J Hosp Palliat Nurs.
.
Abstract
The number of African American adults 65 years and older with end-stage kidney disease receiving maintenance hemodialysis is increasing. The high symptom burden (ie, pain, fatigue, depression) can make it challenging for many to continue dialysis, which can lead to request to withdraw from dialysis. This can present ethical challenges when someone has diminished decision-making capacity and no advance directives or family to assist with this complex decision. This article will provide a brief overview of ethical issues to consider when responding to an older adult’s request to withdraw from a life-sustaining treatment such as dialysis. Suggestions for research to address the gaps in knowledge will be presented.
Copyright © 2022 by The Hospice and Palliative Nurses Association. All rights reserved.
Conflict of interest statement
The authors have no conflicts of interest to disclose.
References
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United States Renal Data System. 2018 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2018.
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Tam-Tham H, Quinn RR, Weaver RG, et al. Survival among older adults with kidney failure is better in the first three years with chronic dialysis treatment than not. Kidney Int. 2018;94(3):582–588. doi:10.1016/j.kint.2018.03.007.
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DOI
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United States Renal Data System. 2017 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2017.
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Flythe JE, Hilliard T, Castillo G, et al. Symptom prioritization among adults receiving in-center hemodialysis. A mixed methods study. Clin J Am Soc Nephrol. 2018;13(5):735–745. doi:10.2215/CJN.10850917.
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Bossola M, Di Stasio E, Marzetti E, De Lorenzis K, Pepe G, Vulpio C. Fatigue is associated with high prevalence and severity of physical and emotional symptoms in patients on chronic hemodialysis. Int Urol Nephrol. 2018;50(7):1341–1346. doi:10.1007/s11255-018-1875-0.
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DOI
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