Table 1.

Potential medical, emotional, and social harms related to dialysis

Medical

Iatrogenic infections

Complications of catheter insertion

Possible acceleration of progressive renal failure

Worsening of pre-existing vascular disease and dementia

Functional decline in vulnerable or frail individuals

Pain with needling of arteriovenous fistula during dialysis

Discomfort with prolonged immobilization

Dialysis-related muscle cramps, headache, and fatigue

Chronic low back pain from persistent abdominal distention in patients undergoing peritoneal dialysis

Feeling of unwellness

Emotional and social

Time and cost associated with commuting to hospital and dialysis centers

Limited employment opportunities

Social isolation (especially if required to move to be closer to a dialysis center)

Leisure travel restrictions

Unnecessary medicalization of death