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Supportive Care for the Renal Patient$
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E. Joanna Chambers, Edwina Brown, and Michael Germain

Print publication date: 2010

Print ISBN-13: 9780199560035

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780199560035.001.0001

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Initiation, withdrawal, and withholding of dialysis: clinical

Initiation, withdrawal, and withholding of dialysis: clinical

(p.231) Chapter 12.1 Initiation, withdrawal, and withholding of dialysis: clinical
Supportive Care for the Renal Patient
Lionel U Mailloux
Oxford University Press

This chapter discusses decision-making in terms of dialysis, whether to withdraw, initiate, or withhold dialysis from a patient, as well as some of the general principles of communications between people with established renal failure and the professionals looking after them. The first section of this chapter presents a number of case studies and scenarios, as well as comments pertaining to these case studies. Before withdrawing or withholding dialysis from a patient, there are a number of factors that need to be considered, such as the possible reversible factors and the presence of an advance directive. The second section provides consideration in starting dialysis, withdrawing from dialysis, and withholding dialysis. The discussion includes a look at the perspective of the patients with regards to decision-making, the role of the family, and the factors relevant to all decisions facing people with ESRD.

Keywords:   decision-making, dialysis, case studies, withdrawing, withholding, factors, advance directive, reversible factors, principles of communications

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