Patient A, a male in his 60’s married with children had several co-morbidities. Together with his family made the decision to cease treatment. Admitted to hospital as a palliative care patient his dialysis was discontinued. Prior to admission he had said goodbye to family and friends and expected that his stay in hospital would be relatively short. This client lived for several months, his renal function improved causing himself and family much distress. He was placed into nursing home care.

Client B, a female in her 70’s residing in a nursing home chose to cease treatment due to increased pain and decreased quality of life. After several weeks in hospital her renal function also improved. She returned to her nursing home and continues to reside there despite ceasing treatment more than 12 months ago.

These 2 case studies demonstrate where early initiation of Renal Replacement Therapy (RRT) was unsuccessful. The cost for RRT per patient per year is approx $50,000-$75,000. With limited haemodialysis machines and places these resources may have been used more effectively elsewhere.

These patients where subjected to haemodialysis access procedures, the stress of undergoing RRT three times per week and the emotional distress which resulted.