A Survey on End-of-Life Contemplation Among Patients on Dialysis

Area of Science:

• Nephrology
• Palliative Care
• Geriatrics

Background:

• High mortality rates in patients undergoing dialysis necessitate acknowledgment of the end-of-life (EOL) phase.
• Understanding patient wishes and planning for EOL care is crucial for this population.

Purpose of the Study:

• To investigate the frequency of end-of-life (EOL) care planning and discussions among patients on dialysis.
• To identify factors associated with EOL care discussions with relatives and nephrologists.

Main Methods:

• A questionnaire-based interview survey was conducted with 268 patients across 7 dialysis centers in Germany.
• Data collected included demographic, socioeconomic, medical factors, and frequency of EOL wish contemplation and discussions.

Main Results:

• 46% of patients on dialysis contemplated their EOL wishes, with 85% discussing them with relatives.
• Only 19% of patients discussed EOL wishes with their nephrologists, though 28% desired such conversations.
• Median age of participants was 70 years, with a median of 3 years on dialysis.

Conclusions:

• A significant portion of dialysis patients contemplate EOL wishes and communicate them to family.
• There is a low frequency of EOL care discussions between patients and nephrologists, highlighting a substantial unmet need.
• Improved integration of EOL care discussions into routine nephrology practice is recommended.