| Theme | Diagnostic and Therapeutic Guidelines in End-stage Renal Failure | |
|---|---|---|
| Title | Initiation of renal replacement therapy, hemodialysis and peritoneal dialysis | |
| Publish Date | 2004/01 | |
| Author | Yoshindo Kawaguchi | Jikei University School of Medicine / Kanagawa Prefectural Hospital Affiliated with Nurses Training School |
| [ Summary ] | Adequate initiation of renal replacement therapy provides essential clues as to attaining patient well-being with maintenance dialysis providing fewer complications and better quality of life. However, it is very difficult to start dialysis under conditions evenly matched to the severity of renal impairment, and to obtain their consent to change his/her life, depending upon artificial methods. This is so even if functioning is severely impaired to a level of less than 10 to 15ml/min of creatinine clearance (GER) and it is difficult to maintain a "Miliue interleur" physiological condition, in terms of patient not being able to recognize overt uremic symptoms. Recently, early referral and early initiation of dialysis has been recommended for better survival with fewer complications with long term dialysis and better rehabilitation. In this review, guidelines for the initiation of dialysis treatment in the United States and EU nephrology communities as well as Japan are introduced. |
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