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When Dialysis is Not a Good Option; a Narrative Review of the Dilemma of Renouncing Renal Replacement Therapy (pp. 43-60) $100.00
Authors:  (José A. Moura-Neto, Ana Flavia Moura, Daniela de Q. Moura, and José Hermógenes Rocco Suassuna)
Abstract:
Nephrologists are often confronted with decisions related to renouncing renal
replacement therapy. Identifying whether dialysis is not a good option for a patient is a
challenge. When survival benefit and superior quality of life are no longer expected,
dialysis becomes a futile therapy and palliative care and conservative treatment may be a
better alternative. This chapter addresses the renunciation of dialysis in its two forms of
occurrence: withdrawing or withholding. We also present the evolution of the guidelines
for renouncing renal replacement therapy as a narrative review and discuss strategies that
may help the decision-making process of nephrologists in these cases. By involving not
just technical, but ethical, legal, cultural, and even economic aspects, the dilemma of
renouncing dialysis is definitely one of the current controversies in renal replacement
therapy. 


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When Dialysis is Not a Good Option; a Narrative Review of the Dilemma of Renouncing Renal Replacement Therapy (pp. 43-60)