Parents Refusing Dialysis for a 3-Month-Old With Renal Failure.
Document Type
Article
Publication Date
3-2018
Identifier
DOI: 10.1542/peds.2017-2096
Abstract
A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed marked bilateral hydronephrosis with little remaining renal cortex in either kidney. A voiding cystourethrogram revealed evidence of posterior urethral valves. The child had no evident comorbidities. Fulguration of the valves was successfully performed but did not lead to improvement in kidney function. The nephrologists recommended the initiation of dialysis with the hope that the child would be able to receive a kidney transplant in the future. After careful consideration, the family stated that they did not want this child to suffer with a lifetime of dialysis and transplant care. They were also concerned about the impact of this child's illness on their other 2 children and their family. They requested that their son be provided with palliative care only. Experts in nephrology, bioethics, and critical care discuss the ethical issues raised by this parental request.
Journal Title
Pediatrics
Volume
141
Issue
3
MeSH Keywords
Cost of Illness; Decision Making; Ethics Committees, Clinical; Hemodialysis, Home; Humans; Infant; Kidney Failure, Chronic; Male; Palliative Care; Parents; Treatment Refusal
Keywords
Cost of Illness; Decision Making; Ethics Committees, Clinical; Hemodialysis, Home; Humans; Infant; Kidney Failure, Chronic; Male; Palliative Care; Parents; Treatment Refusal
Recommended Citation
Willig L, Paquette E, Hester DM, Warady BA, Lantos JD. Parents Refusing Dialysis for a 3-Month-Old With Renal Failure. Pediatrics. 2018;141(3):e20172096. doi:10.1542/peds.2017-2096
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