|Type of care||Dialysis patients||Cancer patients|
|Average number of days hospitalized||9.8||5.1|
|Intensive care unit||48.9%||24.0%|
|Average number of days in ICU||3.5||1.3|
|Ventilator, feeding tube or CPR||29.0%||9.0%|
Source: “Treatment Intensity at the End of Life in Older Adults Receiving Long-term Dialysis,” Archives of Internal Medicine
This is a table just seen in a recent article in Archives of Internal medicine on intensity of treatment at the end of life in older adults receiving long term dialysis. It is an interesting comparison of cancer patients to dialysis patients and one notices that while cancer patients are sick, dialysis patients are sicker and have a higher mortality. Hospitalizations are more, average length of stay and even average intensive care stays are higher. Hospice is rarely offered or chosen in dialysis patients. Check out a post regarding this topic recently as well. Part of this is perhaps Nephrologists are not comfortable offering end of life care to the elderly sick patients during their end of life. Forgoing dialysis is hard for the practicing Nephrologists.
Are our Nephrologists in training comfortable in dealing with end of life issues and providing "No dialysis" in the right circumstance.
And how are they compare to their counterparts in cardiology, oncology, and critical care?
We don't know.
For that, we have created a survey for our fellows to take. Please pass this along to all nephrology fellows you know as this is very important question to answer.