When not to do dialysis?

Speaker- Dr. Alvin Moss
West Virginia

Take home points.

1. Shared decision making is the most important part of end of life care.
2. All Nephrologists need to get familiar with the RPA’s statement on shared decision making and end of life care.
3. Best predictors of mortality in dialysis patients: functional status, age, comorbidities, and nutritional status (comorbidities being a good predictor).
4. The surprise question (Would you be surprised if this patient will be not alive in 6 months?)- Dr Moss discovered that if you answered “No” to this question, this was a best predictor of whom we should not start dialysis on.  This can be asked by nephrologist, ICU physicians, nurse practitioners and even experienced dialysis nurses.
5. The HD mortality predictor calculator can be found at touchcalc.

Post written by Dr. Kenar Jhaveri, eAJKD Blog Editor.

Check out more eAJKD coverage of the NKF’s 2013 Spring Clinical Meetings!