Early Start of Dialysis: A Critical Review

In the US, patients who initiate dialysis "early" (at Modification of Diet in Renal Disease estimated GFR [eGFR]> 10 ml/min per 1.73 m(2)) account for over 50 percent of new dialysis starts. This trend to an early start is based on conventional wisdoms regarding benefits of dialytic cle...

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Bibliographic Details
Published in:Clinical journal of the American Society of Nephrology 2011-05, Vol.6 (5), p.1222-1228
Main Authors: Rosansky, Steven, Glassock, Richard J, Clark, William F
Format: Article
Language:English
Subjects:
Early Diagnosis
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic - diagnosis
Kidney Failure, Chronic - physiopathology
Kidney Failure, Chronic - therapy
Nephrology - standards
Renal Dialysis - methods
Renal Dialysis - standards
Time Factors
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Summary:In the US, patients who initiate dialysis "early" (at Modification of Diet in Renal Disease estimated GFR [eGFR]> 10 ml/min per 1.73 m(2)) account for over 50 percent of new dialysis starts. This trend to an early start is based on conventional wisdoms regarding benefits of dialytic clearance, that albumin levels are nutritional markers, and early dialytic therapy is justified to improve nutrition especially in diabetics and that waiting until low levels of eGFR (i.e.,
ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.09301010