Withholding and withdrawal of dialysis in the elderly

The awareness that many patients eligible for dialysis may live lives in which the burdens of treatment outweigh the benefits has led the renal community to establish guidelines to assist the health care team in advising patients of the potential outcomes of living with or without dialysis. The guidelines published have been personal, consensual, and evidence based. They share in common the principles of shared decision making and informed consent. Only the patient or his surrogate should make the decision regarding initiation or cessation of dialysis.