Hackett Amy S, Watnick Suzanne G
Division of Nephrology and Hypertension, Oregon Health & Science University, Portland VA Medical Center, Portland, Oregon 97239, USA.
Semin Dial. 2007 Jan-Feb;20(1):86-90. doi: 10.1111/j.1525-139X.2007.00249.x.
Dialysis withdrawal is common, accounting for over 20% of patient deaths. It is the third leading cause of death among patients receiving dialysis, after cardiovascular disease and infectious complications. Here we present a case of a patient with significant comorbid disease who ultimately elected to withdraw from dialysis. The medical, social and psychological issues encountered by caregivers are reviewed. Additionally we discuss the available data on factors affecting the decision to withdraw, current practice guidelines, and efforts to educate nephrology fellows on end-of-life issues.
透析撤机很常见，占患者死亡人数的20%以上。它是接受透析患者死亡的第三大主要原因，仅次于心血管疾病和感染性并发症。在此，我们介绍一例患有严重合并症的患者最终选择停止透析的病例。回顾了护理人员遇到的医疗、社会和心理问题。此外，我们还讨论了影响撤机决定的相关数据、现行实践指南，以及在临终问题方面对肾科住院医师进行教育的努力。
