DD: Palliative dialysis in end-stage renal disease

Dialysis patients are often denied hospice benefits unless they forego dialysis treatments. However, many of those patients might benefit from as-needed dialysis treatments to palliate symptoms of uremia, fluid overload, etc. The current Medicare payment system precludes this ‘‘palliative dialysis’ ’ except in those few cases where the terminal diagnosis is unrelated to renal failure. As approximately three quarters of all US patients on dialysis have Medicare as their primary insurance, a of review of Medicare policy is suggested, with a goal of creating a new ‘‘palliative dialysis’ ’ category that would allow patients to receive treatments on a less regular schedule without affecting the quality statistics of the dialysis center.