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Using the institution's renal database, patients who underwent PR-171 datasheet dialysis and died between 1 January 2005 and 30 December 2009 were identified. In order to exclude patients with acute kidney injury, who have a higher mortality rate, only patients who had received either form of RRT for a minimum of 90 days were included. Data extraction focused on patient characteristics including age at commencement of dialysis, age at death, cause of ESKD, previous modalities of RRT and the Charlson comorbidity index (CCI). The CCI is a method of predicting mortality in various disease subgroups, based on the weighting of 19 specified comorbid conditions [12, 13]. The CCI used in this study included a point for every decade over 40 years. To focus on the role of the SPC service, referral patterns were recorded including date of referral and the interval between referral and death. Patient resuscitation status was also reviewed, including the presence of an advance care plan (ACP). We considered an ACP to be a documented discussion about future AZD9291 care between the patient and their care provider. It should include discussions regarding the individual's wishes and their personal goals for care. This definition is based on the NHS National End-of-Life Care Programme Guidelines [14]. To review the EOL care decision process, we investigated if such decisions were made by the medical team alone or if the patient, family member/next of kin (NOK) or both were involved. Only discussions clearly documented in the medical notes could be recorded. We recorded if a decision had been made to withdraw dialysis and whether a documented discussion took place with the patient or a family member/NOK. In cases of withdrawal from dialysis, we recorded the number of days from last dialysis until death. The place of death was categorized as hospital, inpatient hospice, home or elsewhere. Data were extracted using a proforma created in Microsoft Excel. Continuous variables are reporting as mean/median with measures of central tendency and categorical variables are reported as proportions. Comparisons were performed using the ��2, independent samples t-test and one-way analysis of variance, where relevant and a two-sided P-value of YES1 significant. Statistical analysis was performed using SPSS for Macintosh, version 20.0. Results We identified 137 patients who were eligible for the study. Of these, six were excluded due to the lack of baseline data. The modality of RRT prior to death was haemodialysis for 102 (77.9%) patients and peritoneal dialysis for 29 (21.9%). Eighty-eight patients were male (67.2%) and 43 were female (32.8%). The mean age at death was 63.2 �� 15.1 years after a median of 27 months of dialysis (range 3�C318). The mean CCI was 7.9 �� 2.5. CCI and age were significantly correlated (r = 0.564, P