Most patients receiving dialysis said their religious or spiritual beliefs were important to them, which affected their care preferences.1

Researchers surveyed 937 patients receiving dialysis at 31 facilities in Nashville and Seattle from 2015 to 2018. Those for whom religious or spiritual beliefs were more important were more likely to favor a shared decision-making role, more likely to favor resuscitation and mechanical ventilation, and less likely to have considered stopping dialysis.

“We chose to look at this question because we often see how spirituality influences a patient’s approach to serious illness and their end-of-life care preferences,” says Jennifer S. Scherer, MD, the study’s lead author and assistant professor in the divisions of palliative care and nephrology at NYU Grossman School of Medicine.

Despite the importance of spirituality to so many, there is not much research that included dialysis patients. A lot of healthcare providers feel uncomfortable discussing spiritual beliefs.

“This may be a missed opportunity to understand our patients better and to help them make important decisions about their care,” Scherer offers.

Scherer and colleagues were surprised that patients who found spirituality important were no less likely than those who did not to have unmet palliative care needs, and were more likely to report needs related to peer support, pain management, finding hope, and learning about treatment options for the future. They also were no less likely to have engaged in advance care planning. This could mean patients who find spirituality important need assistance in important domains of their care and coping with serious illness.

“It suggests that incorporating their spiritual beliefs into our approach to their care may help us, as providers, better meet the needs of our patients,” Scherer says.


  1. Scherer JS, Milazzo KC, Hebert PL, et al. Association between self-reported importance of religious or spiritual beliefs and end-of-life care preferences among people receiving dialysis. JAMA Netw Open 2021;4:e2119355.