XXXX . Withdrawal from chronic dialysis without medical reason.

@entity1 @entity204
We analyzed @entity1 who died on chronic dialysis because they stopped the treatment, although there was no technical dialysis complication or new medical complication. These @entity1 preferred @entity204 to the stress of dialysis. This occurred in 26/1766 (1.5%) @entity1 , and was responsible for 26/704 (4%) of all @entity204 . We compared these 26 @entity1 to 40 competent @entity1 who discontinued treatment when a medical complication arose. The @entity1 were similar in most respects (age, sex, diagnosis, duration of dialysis, living situation, and type of dialysis) and had the same number of medical complications when starting dialysis. However, the @entity1 who stopped dialysis were more often on home dialysis, 8/24 vs. 3/40 of the other @entity1 (p less than 0.05). Overall, stopping was three times more common in home than in center @entity1 (3.0% vs. 1.1%) (p less than 0.02). Relatives responding to a written interview felt that nurses and social workers but not physicians had been helpful in the difficult time surrounding the @entity1 's decision and @entity204 . This study indicates that particularly home dialysis @entity1 are at a high risk of discontinuing dialysis because of the stress of the dialysis procedure. A realistic introduction to and realization of their dialysis problems, better training and better psychological support, particularly from physicians, are necessary to eradicate this avoidable cause of @entity204 in chronic dialysis @entity1 .
