For some end-stage kidney disease (ESKD) patients, dialysis allows them to live longer and improves their quality of life. For others, dialysis is too uncomfortable, requires too much time, and does not improve their quality of life. Choosing whether or not to do dialysis is a serious decision, and it’s natural to have questions. Here are answers to a few of the most common questions people have when facing this decision.* 

What if I’m Not Sure if Dialysis Can Help Me?

In many cases, it is unclear if the benefits of dialysis will outweigh the burden. Your physician can help answer your questions and explain what dialysis would mean for you. If still uncertain, you may be able to start dialysis treatment for a trial period of a couple of months. During this time, you can:

• See how dialysis makes you feel, 
• Meet and talk with other dialysis patients, and 
• Direct questions to your dialysis healthcare team. 

Who Can I Trust to Help Me Decide?

Based on your medical conditions and overall physical health, your physician can provide insight into how your body will handle dialysis. From a mental and emotional health perspective, there are also great resources to help talk you through your concerns. Speaking with a psychiatrist, social worker, or other counseling professionals will address any mental health concerns and how they may be affected by dialysis. 

Speaking openly with the people in your life who know you best and whom you trust is also helpful. These people care for you and, depending on their relationship to you, will likely be significantly affected by your decision. 

How Long Will I Live if I Choose Not to Start Dialysis?

Every person’s health condition and body is unique. Therefore, there is no certain answer to this question. Depending on a person’s kidney function, how severe their symptoms are, and their overall health, a person with kidney failure may survive days to weeks without dialysis. 

What Happens if I Choose Not to Start Dialysis?

If you choose to not start dialysis, your doctor and healthcare team should still be there to help. Without dialysis treatment, toxins and fluid will build up in your body, making you feel:

• Increasingly tired, 
• Short of breath, 
• Nauseous, and/or 
• Itchy. 

Your doctor can prescribe pain medication, and a treatment called ultrafiltration to remove fluid and make breathing easier. 

Can I Get Hospice Care?

Choosing not to start dialysis with ESKD will make you eligible for hospice services. The type of hospice care may be offered either through a home hospice program or at a hospice facility. Hospice service providers typically include a nurse, aide, and social worker. To learn more about hospice care, talk to your doctor, social worker, or other healthcare professional. 

If I Change My Mind, Can I Start or Go Back to Dialysis?

You can change your mind and start or return to dialysis. If you have a lot of fluid buildup and have missed several treatments, you may have some discomfort when you initially begin again. 

What if I Have More Questions? 

The National Kidney Foundation (NKF) provides a brochure to answer a greater number of frequently-asked questions. For specific questions regarding your health, it is recommended that you discuss them with your doctor and healthcare team. 

*If You Choose Not to Start Dialysis Treatment. (2017, March 24). National Kidney Foundation. Retrieved from https://www.kidney.org/atoz/content/ifyouchoose

“Patient receiving dialysis 03.” by Anna Frodesiak is licensed under CC0 1.0