Social and professional determinants for withdrawing and withholding chronic dialysis among polish pediatric nephrologists, neonatologists and anesthesiologists.

OBJECTIVES The aim of this multicenter nationwide study was to reveal the influence of social and non-medical factors on qualifying children to commence chronic dialysis, to withhold it or to withdraw it. It was also important to compare the real and postulated significance of particular factors that were taken under consideration by pediatric nephrologists, neonatologists and anesthesiologists (intensivists). MATERIAL AND METHODS The survey was addressed to the whole population of specialists dealing with chronic renal replacement therapy for children at key pediatric nephrology centers in Poland. RESULTS Most of the respondents accepted that withholding or withdrawing chronic dialysis is an alternative in certain clinical situations. The statistical analysis showed that the physicians' social characteristics had little influence on their preferences when deciding about withholding or withdrawing chronic dialysis. CONCLUSIONS The study showed that non-medical factors did not influence physicians' attitudes to the problem of withholding or withdrawing chronic dialysis.