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Withholding and withdrawing dialysis in the intensive care unit: benefits derived from consulting the renal physicians association/american society of nephrology clinical practice guideline, shared decision-making in the appropriate initiation of and withdrawal from dialysis.
Clin J Am Soc Nephrol. 2008 Mar; 3(2):587-93.CJ

Abstract

Despite advances in the technology of dialysis, mortality in patients who develop acute renal failure remains high. Scoring systems have been developed to improve the ability to define prognosis in seriously ill patients with acute renal failure but predicting outcomes for individual patients is uncertain. Decisions to withhold or withdraw dialysis in seriously ill patients are difficult for patients, families, and health care providers. The clinical practice guideline, Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis, provides evidence-based recommendations to aid nephrologists in discussions and the process of medical decision-making about starting and stopping dialysis. Estimating prognosis and addressing the issues of advance directives and patient and family preferences through the process of shared decision-making can clarify appropriate strategies for clinical management and interventions. Time-limited trials of dialysis may be an invaluable tool in this process. Increasing nephrologists' awareness of the guideline may facilitate decision-making around the issues of withholding and withdrawing dialysis in part by clarifying patients and situations in which it may be appropriate to withhold or withdraw dialysis.

Authors+Show Affiliations

Division of Renal Diseases and Hypertension, George Washington University, 2150 Pennsylvania Avenue, NW, Suite 1-200, Washington, DC 20037, USA. spatel@mfa.gwu.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18256375

Citation

Patel, Samir S., and Jean L. Holley. "Withholding and Withdrawing Dialysis in the Intensive Care Unit: Benefits Derived From Consulting the Renal Physicians Association/american Society of Nephrology Clinical Practice Guideline, Shared Decision-making in the Appropriate Initiation of and Withdrawal From Dialysis." Clinical Journal of the American Society of Nephrology : CJASN, vol. 3, no. 2, 2008, pp. 587-93.
Patel SS, Holley JL. Withholding and withdrawing dialysis in the intensive care unit: benefits derived from consulting the renal physicians association/american society of nephrology clinical practice guideline, shared decision-making in the appropriate initiation of and withdrawal from dialysis. Clin J Am Soc Nephrol. 2008;3(2):587-93.
Patel, S. S., & Holley, J. L. (2008). Withholding and withdrawing dialysis in the intensive care unit: benefits derived from consulting the renal physicians association/american society of nephrology clinical practice guideline, shared decision-making in the appropriate initiation of and withdrawal from dialysis. Clinical Journal of the American Society of Nephrology : CJASN, 3(2), 587-93. https://doi.org/10.2215/CJN.04040907
Patel SS, Holley JL. Withholding and Withdrawing Dialysis in the Intensive Care Unit: Benefits Derived From Consulting the Renal Physicians Association/american Society of Nephrology Clinical Practice Guideline, Shared Decision-making in the Appropriate Initiation of and Withdrawal From Dialysis. Clin J Am Soc Nephrol. 2008;3(2):587-93. PubMed PMID: 18256375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Withholding and withdrawing dialysis in the intensive care unit: benefits derived from consulting the renal physicians association/american society of nephrology clinical practice guideline, shared decision-making in the appropriate initiation of and withdrawal from dialysis. AU - Patel,Samir S, AU - Holley,Jean L, Y1 - 2008/02/06/ PY - 2008/2/8/pubmed PY - 2008/6/24/medline PY - 2008/2/8/entrez SP - 587 EP - 93 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 3 IS - 2 N2 - Despite advances in the technology of dialysis, mortality in patients who develop acute renal failure remains high. Scoring systems have been developed to improve the ability to define prognosis in seriously ill patients with acute renal failure but predicting outcomes for individual patients is uncertain. Decisions to withhold or withdraw dialysis in seriously ill patients are difficult for patients, families, and health care providers. The clinical practice guideline, Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis, provides evidence-based recommendations to aid nephrologists in discussions and the process of medical decision-making about starting and stopping dialysis. Estimating prognosis and addressing the issues of advance directives and patient and family preferences through the process of shared decision-making can clarify appropriate strategies for clinical management and interventions. Time-limited trials of dialysis may be an invaluable tool in this process. Increasing nephrologists' awareness of the guideline may facilitate decision-making around the issues of withholding and withdrawing dialysis in part by clarifying patients and situations in which it may be appropriate to withhold or withdraw dialysis. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/18256375/Withholding_and_withdrawing_dialysis_in_the_intensive_care_unit:_benefits_derived_from_consulting_the_renal_physicians_association/american_society_of_nephrology_clinical_practice_guideline_shared_decision_making_in_the_appropriate_initiation_of_and_withdrawal_from_dialysis_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=18256375 DB - PRIME DP - Unbound Medicine ER -