Dialysis May Not Be Suitable for Everyone
Not everyone with kidney failure chooses to have dialysis, and there can be many reasons for this.
Some people may feel that dialysis would be difficult to manage, or that travelling to the hospital three times a week would have too much impact on their daily life.
Other health conditions, such as heart disease or other chronic illnesses, can make dialysis treatments particularly challenging.
For people who are easily confused, for example those with dementia, dialysis may feel frightening or upsetting.
Choosing not to have dialysis means that kidney failure will eventually be life-limiting. However, many people who decide against dialysis continue to live with some kidney function remaining and often die from other causes.
There is a wide range of support available to help you and your family make these difficult decisions.
Pearl Siwak (86) tells her story about why she chose conservative care.
Frequently Asked Questions
What care will I receive if I choose not to dialyse?
If you decide not to have dialysis, you will still receive ongoing support from your kidney care team. Your GP will also be informed of your decision.
You will continue to see your kidney doctor regularly, either in clinic or by telephone if travelling to the hospital is difficult.
You may also be referred to community healthcare teams who can help manage your care at home.
How long will I live if I choose not to have dialysis?
It isn’t possible to give a definite timeframe, as everyone is different. How long someone may live can depend on things like how much kidney function they still have and their overall health. For some people, it may be months; for others, it may be years.
How will I feel?
Everyone’s experience is different. Some people feel well even when their kidney function is very low, while others may notice symptoms earlier.
As kidney function declines and the kidneys are no longer able to work effectively, you may begin to notice symptoms such as:
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Feeling very tired or lacking energy
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Nausea (feeling sick)
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Loss of appetite
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Feeling less alert or more confused
Your healthcare team will support you in managing these symptoms and keeping you as comfortable and well as possible.
Copyright © 2016 Alberta Health Services, Conservative Kidney Management
Emotional Support
Choosing not to have dialysis can be a difficult decision.
Support is available for you and your family, including:
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Specialist nurses
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Renal social worker
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Renal counsellor
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Local support groups and charities (e.g. Kidney Care UK)
Advanced Care Planning
When choosing not to have dialysis, it can be helpful to think about your wishes for future care. This is called advanced care planning.
This may include:
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Talking with your family and healthcare team about what matters most to you
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Deciding where you would prefer to be cared for (home, hospital, hospice, care home)
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Letting people know your preferences for treatments in the future
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Completing an Advance Care Plan (ACP) or Advance Decision to Refuse Treatment (ADRT) if you wish
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Appointing a Lasting Power of Attorney (LPA) for health and welfare to help make decisions if you become unable to do so
Your renal team, GP, or palliative care team can support you with these discussions and documents.