演題情報

Symposium

開催回
第60回・2015年・横浜
 

Dialysis withholding/withdrawal: A proposal from the task force of JSDT and the reality in Japan

演題番号 : GI-10-4-4

Hiroyasu Yamamoto:1、Yuzo Watanabe:2

1:Department of Internal Medicine, Atsugi City Hospital, Japan、2:Department of Internal Medicine, Kasugai Municipal Hospital, Japan

 

In Japan, the mean age of incident dialysis patients was 68.7 years in 2013, and continues to increase annually. Diabetic nephropathy has been the most common original renal disease of incident dialysis patients, and the number of patients with serious complications showed a remarkable increase. Recent reports revealed that over 10% patients died of malignant tumors within a year after initiation of dialysis. According to these changes surrounding dialysis treatment, to set up a panel to discuss the future of the dialysis providing system and to establish a managing principle at the terminal stage. However, discussions and announcements against withholding and/or withdrawal of hemodialysis at the terminal stage have been remitted in Japan, but no definitive criteria have been reported from Japanese academic circles related to nephrology. The Japanese Society for Dialysis Therapy has established “The study subgroup on withholding and withdrawal of dialysis” in 2011. And we have come to present the proposal for “The Shared Decision-Making Process Regarding Initiation and Continuation of Maintenance Hemodialysis”. The basic policy of this proposal is that the decisions of medical practice should not be made by the doctor alone; instead, they should be made by a medical team with sufficient support and information from the medical staff to the patient, thereby enabling the patients themselves to make an accurate, autonomous decision. The right of dying with dignity has not been established by law in Japan. We should discuss the important issues further.

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