This guideline applies to patients with stage 4 to 5 acute or chronic kidney disease (eGFR below 30ml/min) whether receiving dialysis or not.

Advance care planning should take place prior to consideration of stopping dialysis. Median survival after renal dialysis withdrawal is 9 days, but some patients with residual renal function may live much longer and need continuing care.  If they pass urine they are likely to live longer than if they have minimal urine output.

Other relevant guidelines include: Last days of life, Subcutaneous medication, Alfentanil and Fentanyl.