Do doctors with kidney failure choose dialysis?

[SteveGus]

Google has failed me here.  Simple question:

Do doctors whose kidneys have failed them put up with dialysis?  Or do they recognize that by that stage the jig is up?  Is it one more of the medical interventions that doctors choose not to choose for themselves? 

[Michael Murphy]

During my 4 years I have met 4 or 5 doctors in a 18 seat  center.  That is over the last 4 years.  From what I have heard is that they will go for dialysis but will stop if a cancer diagnosis is made.

[Simon Dog]

An interesting article mentions that 93% of nephs would choose some sort of home therapy if they were the patient awaiting transplant, and 96% if transplant were not an option:

http://www.satellitehealth.com/pdf/SHC_362_Dr_Schiller_article_Rev.pdf

[Riki]

Do any of us "choose" dialysis?  Isn't it thrust upon us?  I mean, the choice is dialysis or death.  I know I wasn't even given a choice, as I was too young.  I don't think the thought of NOT doing dialysis occurred to my parents at the time, and as much as I swore I'd never do dialysis again, I did.  Twice.  I'll continue to do dialysis until it's no longer a viable option.  I think there are too many people out there who would disappointed in me if I gave up too easily.

[SteveGus]

During my 4 years I have met 4 or 5 doctors in a 18 seat  center.  That is over the last 4 years.  From what I have heard is that they will go for dialysis but will stop if a cancer diagnosis is made.

Not a representative sample!    Though it is helpful.  Like you, what I've heard is that doctors reject most chemotherapies and cancer treatments that buy time at the expense of comfort for terminal cases.  They also do what they can to let everyone know they don't want CPR.  This is what got me wondering. 

An interesting article mentions that 93% of nephs would choose some sort of home therapy if they were the patient awaiting transplant, and 96% if transplant were not an option:

http://www.satellitehealth.com/pdf/SHC_362_Dr_Schiller_article_Rev.pdf

This too is helpful, though again, the question of how many would simply reject any treatment does not appear to have been asked.  I gather that their preferred methods are unheard of or not sustainable in these parts, because nothing other than hemodialysis at a center was ever presented as an option to me, or even the idea that it was optional. 

[cassandra]

Steve have you contacted the Kidney Foundation about that? Or a kidney support group in your area?
I rang Nxstage to ask if there were any Nxstagers in the NorthWest of England. They said 'a few', than I rang all hosps in my area to find out.

Love, luck and strength, Cas

[Michael Murphy]

I recently had a major heart attack after the first set of surgery I was unable to walk the 8 feet from my bed to the toilet with out gasping for air.  That's when I realized that this was going to be no way to live.  I was upst until I realized that I had the option of stopping dialysis.  I told my doctor this and they were not pleased  but I was happy,  another angioplasty and I could walk to the toilet. 

[iolaire]

A lot of these types of questions require context.  Doctors might "reject" chemotherapy, but I bet of they or a loved one had entry level breast cancer which is treatable by chemotherapy they would not reject it.  I believe doctors are against things that might extend their lives for a few months at a high level of inconvenience. 

So when you talk dialysis they might pass on it if they are basically terminal already but I'd guess they would be happy for treatments if that would get them back healthy and keep them living for many years.

But one caution there is many people are struggling when they start dialysis and in a few weeks are significantly better looking.  So don't judge how someone will survive dialysis until you give it a chance for a month or so.  I see various people in my center start out on dialysis and they can barely interact with the staff, cannot really walk but within a few weeks they are responsive and much more mobile.

[smartcookie]

I don't know if this is helpful at all, but my dad is an OB/GYN.  He has had stage 4 bladder cancer.  The tumor was found when he could not pass a kidney stone and my dad underwent treatment, but not chemo.  His doctor injected a modified TB strand into his bladder to help his own immune system fight the cancer.  This was back in 2008.  If he has a reoccurrence, the doctor is going to remove his bladder.  As for dialysis, I have talked with him about that.  He would do PD and go for a transplant. 

[Rerun]

There was a doctor on the same shift as me in Sacramento, and he was on dialysis but would NOT get a fistula.  He had a catheter and I could hear his Nephrologist trying to talk him into a fistula and No Go.  It made me wonder what he knew that I didn't.  At that point I had a fistula but wasn't using it yet.  They would ask when I was ready to use it and I'd point to the doctor on dialysis and say "when he uses one"  LOL

[SteveGus]

There was a doctor on the same shift as me in Sacramento, and he was on dialysis but would NOT get a fistula.  He had a catheter and I could hear his Nephrologist trying to talk him into a fistula and No Go.  It made me wonder what he knew that I didn't.  At that point I had a fistula but wasn't using it yet.  They would ask when I was ready to use it and I'd point to the doctor on dialysis and say "when he uses one"  LOL

I had my catheter removed as my kidney doctor and the clinic staff demanded.   Now I have something apparently called 'steal syndrome' and have lost the use of my once good hand.  I regret having the catheter removed every time I go, and have asked for its reinstallation but no one listens. 

[KatieV]

It made me wonder what he knew that I didn't. 

You should have asked him. 

Years ago, my father had disc issues in his lower back.  He was referred to a specialist who said he could operate.  He asked the surgeon what he would do if he had this problem.  The surgeon THEN told him that the rates of reoccurrence was high and there was no discernible difference between the surgery and exercise to strengthen the back.  My dad opted out of the surgery, had a set of exercises he did daily for months/years, and hasn't had a major problem since.

Would the surgeon have offered that information without being asked?  Maybe, maybe not.

[Fabkiwi06]

The first question I ask my neph before any major decision is what would she do or what she would recommend if I was her daughter. I've been very glad she steered me towards PDC. But, like it was mentioned before, I'm still under 30 and in decent shape other than the kidneys... it's pretty unlikely that anyone is gonna recommend for me to stop treatment.

[justagirl2325]

I had my catheter removed as my kidney doctor and the clinic staff demanded.   Now I have something apparently called 'steal syndrome' and have lost the use of my once good hand.  I regret having the catheter removed every time I go, and have asked for its reinstallation but no one listens.

Same thing with my husband (except he had no choice to have catheter removed due to infection).  We hope it can be taken out or reversed or whatever they do after transplant.