Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

End-of-Life Experience of Older Adults Dying of End-Stage Renal Disease: A Comparison With Cancer.

Wachterman MW, Lipsitz SR, Lorenz KA, Marcantonio ER, Li Z, Keating NL. End-of-Life Experience of Older Adults Dying of End-Stage Renal Disease: A Comparison With Cancer. Journal of pain and symptom management. 2017 Dec 1; 54(6):789-797.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


CONTEXT: Older adults with end-stage renal disease (ESRD) are a rapidly growing group of seriously ill patients. Yet, despite a mortality rate almost twice that of cancer, less is known about the impact of ESRD on patients'' end-of-life experience. OBJECTIVE: To compare the end-of-life experience of older adults who died of ESRD vs. cancer. METHODS: We used data from the Health and Retirement Study, a nationally representative survey of older adults. Our sample included 1883 Health and Retirement Study participants who died of cancer or ESRD between 2000 and 2010 and their family respondents. We compared advance care planning, treatment intensity, and symptoms between the two groups and used propensity score weighting to adjust for differences by diagnosis. RESULTS: Among propensity-weighted cohorts, older adults with ESRD, compared with similar patients with cancer, were less likely to have end-of-life instructions (adjusted proportions 38.5% vs. 49.7%; P  =  0.005) and were more likely to die in the hospital (53.5% vs. 29.0%; P  <  0.001) and to use the intensive care unit in the last two years of life (57.1% vs. 37.0%; P  <  0.001). Decedents with ESRD and cancer had similarly high rates of moderate or severe pain (53.7% vs. 57.8%; P  =  0.34) and all other symptoms. CONCLUSION: Older adults dying of ESRD had lower rates of advance care planning and higher treatment intensity near the end of life than similar patients dying of cancer; both groups had similarly high rates of symptoms. Efforts are needed to make treatment more supportive and alleviate suffering for older adults with ESRD and their families near the end of life.

Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.