Many Nephrologists Unprepared to Make End-of-Life Decisions

60% cited unease, while more-experienced kidney specialists did not

FRIDAY, Sept. 29, 2006 (HealthDay News) -- More than half of nephrologists report feeling unprepared to make the decision to stop dialysis in kidney-disease patients nearing the end of their life, new research finds.

In a study in the November issue of the Clinical Journal of the American Society of Nephrology, researchers from the University of Alberta, in Edmonton, Canada, and colleagues surveyed 360 American and Canadian nephrologists about their role in end-of-life decision-making.

The researchers found that 60 percent of the nephrologists reported not feeling well-prepared to withhold or withdraw dialysis in patients with kidney disease nearing the end of life.

"This is not surprising, given that end-of-life care is not well addressed in nephrology specialty training programs," Dr. Sara Davison, lead author of the study, said in a prepared statement.

The nephrologists who were more comfortable making end-of-life decisions tended to be older and more experienced than those who felt less comfortable.

Another key factor was awareness of the Renal Physicians Association and American Society of Nephrology's formal guidelines for end-of-life decision-making.

Seventy percent of nephrologists who were comfortable with end-of-life decision-making were familiar with the guidelines, compared with 53 percent of those who were less confident.

More information

The Family Caregiver Alliance has more about end-of-life decision-making.

SOURCE: American Society of Nephrology, news release, Sept. 13, 2006
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