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Invited Commentary
June 2018

Hospice Use and End-of-Life Care for Patients With End-stage Renal Disease: Too Little, Too Late

Author Affiliations
  • 1Division of Vascular Surgery, Department of Surgery, University of Wisconsin–Madison, Madison
  • 2Department of Medical History and Bioethics, University of Wisconsin–Madison, Madison
  • 3Department of Medicine, University of Wisconsin–Madison, Madison
JAMA Intern Med. 2018;178(6):799-801. doi:10.1001/jamainternmed.2018.1078

Patients with end-stage renal disease (ESRD) have life-limiting illness. Although the mortality risk of ESRD can be mitigated for patients who receive a renal transplant, renal replacement therapy does not confer the same benefit. Given the high rates of mortality and the burdens associated with dialysis, attention to the care that these patients receive at the end of life is important. Using a data set that covers a generous portion of patients in the United States with ESRD, the study by Wachterman and colleagues1 in this issue of JAMA Internal Medicine reveals that the care at the end of life for patients receiving hemodialysis is categorically different from the care at the end of life for patients with other terminal illnesses.

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