A research letter published in the journal Archives of Internal Medicine has reported that patients with end stage renal disease tend to receive very aggressive treatment during their last month of life.

The researchers from the University of Washington analysed data on almost 100,000 Medicare patients who were treated with dialysis, and found that during the last month of life 76% of patients were hospitalized (compared to 61% of cancer patients). The data also showed that the average hospital stay for those with end stage renal disease was double that of cancer patients (10 days compared to just 5 in the cancer group).

Not only were dialysis patients more likely to be hospitalized, they were also three times more likely to receive intrusive procedures (including the placement of feeding tubes and mechanical ventilation).

Interestingly, the authors found that amongst the study population, those who lived in areas with a high end-of-life care spending capacity, were more likely to receive aggressive treatment. This suggests that budgetary factors, rather than patient preferences, may well be driving the end of life care decisions of healthcare workers.

These findings offer a useful insight into the experiences of end-stage renal disease patients, an area in which little research has been published.