ESRD, stopping dialysis

[84RN]

I work in home health and have a long-time dialysis patient that is considering hospice. He's in his 90's and has multiple comorbities, is just frail and tired at this point.

How long would he live if he stopped dialysis? What would the course of his last days/weeks be like?

[Lev, MSN, RN, NP]

I think he would live about 2 weeks, depending on comorbidities. How are his creatinines before dialysis? Not exactly sure what the course would look like. Probably some electrolyte imbalances that may or may not make him uncomfortable. Probably mental status changes at the end. A hospice nurse would be able to answer this better than me.

[toomuchbaloney]

There is no way to predict the timing of the decline and death.

I watched an ESRD patient resume making urine after years of dialysis and spent months on hospice at home. It was very unusual, to say the least, but the patient and family were obviously thrilled.

Typically the decline and death are quick and symptoms are easily palliated when dialysis is DC'd.

[annie.rn]

I took care of two in my time working hospice. Both died very quickly (

[johnys]

It would depend to a large degree on what, if any, renal function they have left. If zero, then can plan on a short Hospice stay. There is always the unexpected...had one lovely 93 yr old lady come off dialysis, slipped into a coma on day 5, and unfortunately bled out on day 6, from somewhere we will never know. She was comfortable, but it was not what we had hoped for to say the least.