The Hidden Complexity of Dialysis Withdrawal: A Case Report

Kidney supportive care (KSC) incorporates palliative care principles into nephrology, encompassing the full spectrum of kidney disease. Dialysis withdrawal, a component of kidney supportive care (KSC), presents a challenging, complex, and emotionally demanding therapeutic option. As patients experience increasing physical dependence on treatment, healthcare professionals may avoid or defer discussions regarding its withdrawal, making it more difficult for patients and their families to cope with decisions regarding end­ ‑of­ ‑life care. The ideal withdrawal involves a carefully considered, patient­ ‑centered decision to minimize suffering and psychological discomfort for the family. This case report details the management of a patient with end­‑stage chronic kidney disease on kidney replacement therapy whose dialysis was temporarily suspended due to an initial misdiagnosis of cancer. It underscores the critical importance of multidisciplinary collaboration and the challenges of complex therapeutic decisions such as dialysis withdrawal, especially in an inpatient setting.