Parents refusing dialysis for a 3-month-old with renal failure

Laurel Willig, Erin Paquette, D. Micah Hester, Bradley A. Warady, John D. Lantos*

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed marked bilateral hydronephrosis with little remaining renal cortex in either kidney. A voiding cystourethrogram revealed evidence of posterior urethral valves. The child had no evident comorbidities. Fulguration of the valves was successfully performed but did not lead to improvement in kidney function. The nephrologists recommended the initiation of dialysis with the hope that the child would be able to receive a kidney transplant in the future. After careful consideration, the family stated that they did not want this child to suffer with a lifetime of dialysis and transplant care. They were also concerned about the impact of this child's illness on their other 2 children and their family. They requested that their son be provided with palliative care only. Experts in nephrology, bioethics, and critical care discuss the ethical issues raised by this parental request.

Original languageEnglish (US)
Article numbere20172096
JournalPediatrics
Volume141
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Renal Insufficiency
Dialysis
Parents
Kidney
Failure to Thrive
Nephrology
Transplants
Bioethics
Hydronephrosis
Critical Care
Nuclear Family
Palliative Care
Ethics
Urea
Comorbidity
Creatinine
Nitrogen
Serum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Willig, L., Paquette, E., Hester, D. M., Warady, B. A., & Lantos, J. D. (2018). Parents refusing dialysis for a 3-month-old with renal failure. Pediatrics, 141(3), [e20172096]. https://doi.org/10.1542/peds.2017-2096
Willig, Laurel ; Paquette, Erin ; Hester, D. Micah ; Warady, Bradley A. ; Lantos, John D. / Parents refusing dialysis for a 3-month-old with renal failure. In: Pediatrics. 2018 ; Vol. 141, No. 3.
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Willig, L, Paquette, E, Hester, DM, Warady, BA & Lantos, JD 2018, 'Parents refusing dialysis for a 3-month-old with renal failure', Pediatrics, vol. 141, no. 3, e20172096. https://doi.org/10.1542/peds.2017-2096

Parents refusing dialysis for a 3-month-old with renal failure. / Willig, Laurel; Paquette, Erin; Hester, D. Micah; Warady, Bradley A.; Lantos, John D.

In: Pediatrics, Vol. 141, No. 3, e20172096, 01.03.2018.

Research output: Contribution to journalArticle

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