Dialysis Is a Way of Life for Many Older Patients. Maybe It Shouldn’t Be

John Everdell had lived most of his life with kidney disease. As a young man awaiting a transplant, he had briefly undergone dialysis. That’s how he knew, when the prospect of kidney failure loomed again in his late 60s, that he would refuse dialysis this round.

“He was a very independent man, with an idea of how he was going to live his life,” said Trix Oakley, his partner of 22 years.

“He didn’t want to be tied down to the routine, having to report to the dialysis clinic every other day. He didn’t like the ups and downs — feeling good but washed-out, then feeling crummy. He didn’t like being attached to the machine.”

A woodworker and furniture maker, Mr. Everdell had been in his 30s when he was first diagnosed with kidney disease. By his 60s, he had received two transplants, with kidneys donated by his siblings.

But in recent years, living in Cambridge, Mass., he and Ms. Oakley could see that his second transplanted kidney was faltering. The readings on his monthly blood tests grew troubling; he felt cold and tired; his hands and feet began to swell. His doctors again suggested dialysis.

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