Strategies for Timely and Effective Hospice Discussions: End-Stage Renal Disease
Authors: Michael J. Germain, Lewis M. Cohen, Alvin H. Moss
Journal: Annals of Internal Medicine (2007)

Letters4 December 2007Strategies for Timely and Effective Hospice Discussions: End-Stage Renal DiseaseMichael J. Germain, MD, Lewis M. Cohen, MD, and Alvin H. Moss, MDMichael J. Germain, MDFrom Tufts University School of Medicine, Baystate Medical Center, Springfield, MA 01199, and West Virginia University School of Medicine, Morgantown, WV 26506-9022.Search for more papers by this author, Lewis M. Cohen, MDFrom Tufts University School of Medicine, Baystate Medical Center, Springfield, MA 01199, and West Virginia University School of Medicine, Morgantown, WV 26506-9022.Search for more papers by this author, and Alvin H. Moss, MDFrom Tufts University School of Medicine, Baystate Medical Center, Springfield, MA 01199, and West Virginia University School of Medicine, Morgantown, WV 26506-9022.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-11-200712040-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Casarett and Quill describe excellent strategies for discussing hospice and supportive (palliative) care with patients and families, including how to overcome the barriers to such discussions (1). Absent from Table 1 is a common condition with an increasing incidence and worse mortality rate than the other conditions listed: end-stage renal disease (ESRD). Incident dialysis patients have a 1-year mortality rate of 20% to 30% (2). The median survival for patients older than 80 years of age starting dialysis is 15.6 months; this is one fifth of the survival of an age-matched cohort without ESRD (3). Murray and ...References1. Casarett DJ, Quill TE. “I'm not ready for hospice”: strategies for timely and effective hospice discussions. Ann Intern Med. 2007;146:443-9. [PMID: 17371889] LinkGoogle Scholar2. U.S. Renal Data System. USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2006. Google Scholar3. Kurella M, Covinsky KE, Collins AJ, Chertow GM. Octogenarians and nonagenarians starting dialysis in the United States. Ann Intern Med. 2007;146:177-83. [PMID: 17283348] LinkGoogle Scholar4. Murray AM, Arko C, Chen SC, Gilbertson DT, Moss AH. Use of hospice in the United States dialysis population. Clin J Am Soc Nephrol. 2006;1:1248-55. [PMID: 17699355] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael J. Germain, MD; Lewis M. Cohen, MD; Alvin H. Moss, MDAffiliations: From Tufts University School of Medicine, Baystate Medical Center, Springfield, MA 01199, and West Virginia University School of Medicine, Morgantown, WV 26506-9022.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOctogenarians and Nonagenarians Starting Dialysis in the United States Manjula Kurella , Kenneth E. Covinsky , Alan J. Collins , and Glenn M. Chertow “I'm Not Ready for Hospice”: Strategies for Timely and Effective Hospice Discussions David J. Casarett and Timothy E. Quill Strategies for Timely and Effective Hospice Discussions: End-Stage Renal Disease David J. Casarett and Timothy E. Quill Metrics Cited byConsensus guidelines for the definition of the end stage of disease and last days of life and criteria for medical judgmentDoc, Don't Procrastinate…Rehabilitate, Palliate, and Advocate 4 December 2007Volume 147, Issue 11Page: 816KeywordsConflicts of interestDeath ratesMedical dialysisMedicarePalliative carePatientsRenal failure ePublished: 4 December 2007 Issue Published: 4 December 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...