For any patient on dialysis, there may come a time when he or she may feel that dialysis no longer improves their quality of life or meets their personal and health care goals. If this happens, the patient has the right to discontinue dialysis treatments and opt for conservative care.
If you feel that dialysis is no longer a suitable treatment option for you and would like to stop this treatment, first, it is extremely important to discuss your decision with your loved ones and your care team (kidney doctor, nurse, dietician, social worker, etc.).
Your care team will want to understand precisely why you would like to stop dialysis. The reasons to discontinue treatment may include worsening health, depression, changing personal goals, declining quality of life on dialysis, and others. In some cases, your doctor may be able to make adjustments to your treatment routine that may improve your situation and influence your decision to stop.
If your decision is final, your care team will be able to explain in detail what happens to your body when you stop dialysis as well as what kind of care you will receive once you stop. Your care team will be available to you regardless of your decision to discontinue dialysis.
The decision to stop dialysis can be reversed at any time. However, a patient may have adverse health consequences from a lack of treatment even if dialysis is restarted. If you decide to restart the treatments after stopping them, talk to your care team immediately.
Stopping dialysis is not considered suicide. It is a well-recognized and accepted treatment choice that results in a natural death due to kidney failure.
In general, when a patient with kidney failure decides to stop dialysis, he or she may expect to live between several days and several weeks, depending on their health condition, while their body naturally declines and eventually dies.
Without dialysis, toxic wastes and fluid will build up in the body, and the patient will feel tired and drowsy, eventually slipping into a state of unconsciousness. Death will usually occur from organ failure when the patient is unconscious. Any negative symptoms such as pain, nausea or difficulty breathing can be reasonably controlled with medication that a doctor (family physician, kidney specialist or palliative care specialist) will be able to prescribe depending on a patient's individual situation.
You can find more information on stopping dialysis in this Kidney Foundation of Canada pamphlet. For more information on conservative care see this BC Renal Agency's Modality Choices Presentation.