Nearly one in 10 patients with ESRD undergo lower extremity amputation in their last year of life, while also having prolonged stays in health care settings and limited access to hospice services, according to a study published in the Journal of the American Society of Nephrology.

“These findings are concerning because despite wide-spread recognition that lower extremity amputation often means a poor prognosis for patients with ESRD, and that the event should prompt discussion about end-of-life preferences, this study suggests that end-of-life care for these seriously ill patients may not align with the kind of care that many seriously ill patients say they prefer — that is, to die at home and focus on comfort rather than life prolongation,” Catherine R. Butler, MD, of the University of Washington School of Medicine in Seattle, said in a press release.