| Theme |
Considering the timing of chronic dialysis (renal replacement therapy) initiation |
| Title |
Timing of dialysis initiation for diabetic patients |
| Author |
Izumi Nyumura |
Diabetes Center, Tokyo Women's Medical University School of Medicine |
| Author |
Tetsuya Babazono |
Diabetes Center, Tokyo Women's Medical University School of Medicine |
| [ Summary ] |
The number of end-stage renal disease (ESRD) patients with diabetes in Japan has increased. As a result, diabetic kidney disease (DKD) has become the number one cause of dialysis initiation. The criteria for dialysis initiation for ESRD patients consists of graded clinical presentations determination of kidney function and kidney levels in daily life. These methods have been used extensively since the Health and Welfare Ministry proposed the criteria in 1991.
However, ESRD patients with DKD experience various complications including accumulation of fluids and macrovascular disease. These complications make it difficult decide on timing to initiate dialysis by examining only renal function. On the other hand, early initiation of dialysis has caused an increase in unnecessary medical spending and has lead to decreased quality of life for these patients. It is necessary to discuss the timing of dialysis initiation, for individuals. |