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 a patient feels that dialysis is no longer a suitable treatment option for them and would like to stop this treatment, first, it is extremely important to discuss their decision with their loved ones and their care team (kidney doctor, nurse, dietician, social worker, etc.).
The care team will want to understand precisely why the patient 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, the patient's doctor may be able to make adjustments to the patient's treatment routine that may improve their situation and provide more information or context to assist in their decision to stop.
If the patient's decision is final, their care team will be able to explain in detail what happens to their body when they stop dialysis as well as what kind of care the patient will receive once they stop. The patient's care team will be available to them regardless of their decision to discontinue dialysis.
The decision to stop dialysis can be reversed at any time. If the patient decides to restart dialysis after stopping, he or she should talk to their 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.
The experience and symptoms of patients who choose to stop dialysis can vary significantly. Most commonly, the patient will feel tired and drowsy, and may eventually slip into a state of unconsciousness.
Patients who choose to stop dialysis should be aware that 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 the 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.