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Opting out of dialysis not an immediate death sentence in advanced kidney disease


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Journal
JAMA Network Open
Reuters Health - 14/03/2022 - Many older patients with advanced chronic kidney disease (CKD) who forgo dialysis survive several years with good quality of life until late in their illness course, new research suggests. "Our findings challenge the common misconception that the only alternative to dialysis for many patients with advanced CKD is no care or death," Dr. Susan Wong of the University of Washington, in Seattle, and colleagues write in JAMA Network Open. The findings are based on a systematic review including 41 cohort studies comprising 5,102 older adults with advanced CKD who did not pursue maintenance dialysis. Median survival ranged from one to 41 months, corresponding to a wide range of baseline mean estimated glomerular filtration rate (range, 7 to 19 mL/min/1.73 m2). "Despite the advanced ages and significant comorbid burden of cohorts in this study, most patients survived several years after the decision to forgo dialysis was made," the...


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