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Factors associated with elective withdrawal of maintenance hemodialysis: A case-control analysis

American Journal of Nephrology Feb 11, 2020

Wetmore JB, et al. - To better understand links of demographic factors with elective dialysis withdrawal and setting of death, patterns of illness trajectories preceding death, and to gain insight into the association of illness trajectories, especially worsening putative disability, with elective withdrawal, researchers undertook this case-control analysis with hemodialysis patients who died in 2010–2015. They used United States Renal Data System data. Females vs males were more likely to withdraw. Withdrawl was more likely to be seen in the most rural patients vs the most urban. Less withdrawal related to Medicaid coverage was reported. A strong link of disability proxy score with withdrawal was identified. In women and minorities vs in men and whites, findings revealed more common in-hospital death and death in the intensive care unit, but these were less commonly reported in most rural patients. Experts concluded that patients who electively withdraw can be distinguished from those who die of non-withdrawal causes by considering important differences noted in this study. Worsening disability, specifically, may serve as a marker for withdrawal.
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