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Dialysis vs. Conservative Care for the Elderly Patient with ESRD

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Dr Ann M O Hare Seattle    02 December 2019

  • Dialysis is a life-extending treatment.
  • Poor outcomes among US nursing home residents treated with dialysis.
  • It is hard for US patients with advanced kidney disease to avoid dialysis.
  • US nephrologists do not feel supported in their efforts to provide conservative care.
  • Roadmap for conservative care in US.
  • Adapt existing models of conservative care from outside the US
  • Infrastructure and investment to support development of conservative care models
  • Community and societal commitment to support the option of conservative care in proactive (noncrisis-driven) fashion
  • Tools to facilitate communication around treatment options, including conservative care
  • More flexible approach to provision of conservative care and transitions between care models (delaying onset of dialysis, supporting those who are not sure whether they want to start dialysis).

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