If kidney dialysis is helping you live with chronic kidney disease or failure, stopping can mean that you’re reaching the end of your life.
Kidney dialysis is performed when your kidneys are no longer able to perform their usual functions. You can stop getting dialysis whenever you and your doctors feel the time is right.
But if the treatment is helping you live with chronic kidney disease or failure, stopping can mean that you’ll only have a few days or weeks left to live.
Read on to learn what research says about survival times after stopping dialysis, what to consider before stopping dialysis, and what next steps you can take after making such a decision.
When you go into kidney failure, toxic substances build up in your body and your organs gradually begin to shut down. Some people with end-stage kidney disease survive longer than others after stopping dialysis, but the timeframe is typically somewhere between a few hours and a few weeks.
The study noted several factors that may have affected the survival time of people in hospice, including:
- sex assigned at birth
- coming directly to hospice care after a hospital stay for another illness
- functional health status (level of consciousness, mobility/activity levels)
- fluid buildup in the hands or legs (peripheral edema)
There’s no exact answer for how long you’ll live after stopping kidney dialysis. This can depend on:
- how well your kidneys are still functioning
- how advanced or severe any other conditions you have are
- what stage of kidney disease you’re in
A 2016 anecdotal report by a California nephrologist reported that someone they treated with very minimal kidney function lived for 2 years before passing away at home with her family.
Deciding to stop dialysis is a personal choice. Here are some things to consider before you make this consequential decision.
Is it really my choice to stop dialysis?
It is your right to choose when you’re ready to stop dialysis.
Consider speaking with a doctor, other specialists involved in your treatment plan, and your family and loved ones before you stop dialysis. You should also make a plan for how you want to manage your care after you stop dialysis.
How will my healthcare team respond to my decision?
Your providers will want to help you make the best decision for you. They will help you weigh the pros and cons of stopping kidney dialysis. Be clear and transparent about why you want to stop dialysis. This can help doctors, specialists, and social workers advise you about any other treatments or care options that may help address your concerns.
How should I speak with my loved ones about my decision?
Be honest with the people you care about why you made this decision. Don’t feel pressured to give excuses that aren’t true to your feelings or reverse your decision to please someone else.
Consider asking a doctor or healthcare professional to help explain your reasoning to your loved ones — having an expert in the room can sometimes bring a neutral stance to these difficult conversations.
Are there other treatments that can help with my quality of life?
Some possible alternatives to dialysis can include:
- getting a kidney transplant from a living or deceased donor
- getting a weekly injection of erythropoietin to help with anemia related to kidney disease
- receiving treatment for high blood pressure
Even if treatment isn’t available to extend your life, palliative care is available to make you feel comfortable in your final weeks or months.
Is stopping dialysis considered suicide?
Suicide is when someone chooses to injure themselves in order to end their own life. Discontinuing medical treatment is different from suicide. You have the right to stop medical treatments that you believe are doing you more harm than good.
But, stopping dialysis means that your organs will shut down, which leads to death. People with kidney failure are able to live on dialysis for many years, even many decades. Before you stop treatment, your provider may encourage you to speak with a mental health professional, especially if you are young or in otherwise good health.
A mental health professional, such as a therapist or social worker, can help you cope with depression as you navigate this difficult decision.
How long do I live after stopping dialysis?
You can live anywhere from a week to a month or more after stopping dialysis depending on your health, kidney function, and other treatments you receive.
What should I expect after stopping dialysis?
You’ll start to feel more and more tired over time as your kidneys stop functioning.
Dying from kidney failure alone doesn’t cause pain. But if you’re experiencing pain from other conditions, a doctor may recommend medications to ease your pain.
You may also take diuretics to help your body drain extra fluids so that you don’t swell from fluid buildup and your breathing isn’t constricted.
What kind of diet should I follow?
You may be able to resume any diet as you see fit because you’ll no longer be required to follow a diet. However, to improve end-of-life quality, consuming as little potassium as possible may still be important. Speak with a doctor about what diets you may want to avoid to prevent salt or fluids from building up too much in your body.
Will I still be treated by the team taking care of my kidney health?
Yes. Doctors, nurses, social workers, and others involved in your care will continue to help offer treatment, advice, and arrangements for you to receive alternative treatments or palliative care at home.
Can I get hospice care?
You can usually choose hospice care if stopping dialysis means that you’re in the final weeks or months of your life.
Hospice can be done at home or at a facility. Consider speaking with a social worker who can help you arrange for the type of hospice care you want.
Can I choose where I die?
Yes. You can usually choose the specific place you’d like to spend your final weeks and months.
Health insurance and your condition may factor into the exact location you can stay if you choose a hospital or hospice facility.
Can I get treatment if I choose to die at home?
Health insurance is the biggest factor in deciding what treatments are available to you at home.
You may be assigned a home health aide if you do hospice care at home. This can either be covered by a health insurance plan or be paid for out of pocket if you choose a service that isn’t covered by an insurance plan.
Stopping dialysis treatment means that you may need to make some additional considerations, including:
- Deciding on your exact medical care: Most insurance plans, including Medicare, don’t stop if you decide not to continue with dialysis. But your exact coverage may vary depending on the option you choose such as hospice or home care.
- Understanding whether dialysis is still an option: You can change your mind and start dialysis again. Speak with a doctor to see if dialysis will still help if you’ve missed a few treatments and your kidney disease has advanced.
- Naming someone to make your medical decisions: If you’re concerned that you’ll become unable to make your own decision, speak with a family member or loved one to make a living will or give them power of attorney for your healthcare decisions.
- Discussing your plans with those close to you: Make an end-of-life plan so that you can begin to make arrangements with doctors, social workers, family members, and others who may take part in your plans.