| Theme | Informed Consent and Preparation on Renal Replacement Therapy for Patients with End Stage Renal Disease | |
|---|---|---|
| Title | Informed consent and preparation for hemodialysis in end-stage renal failure | |
| Publish Date | 2009/11 | |
| Author | Mariko Miyazaki | Department of Nephrology, Sendai Shakaihoken Hospital |
| Author | Katsuya Ishiyama | Department of Nephrology, Sendai Shakaihoken Hospital |
| Author | Akira Torigoe | Department of Nephrology, Sendai Shakaihoken Hospital |
| Author | Yasunobu Miyasaka | Department of Nephrology, Sendai Shakaihoken Hospital |
| Author | Toshinobu Sato | Department of Nephrology, Sendai Shakaihoken Hospital |
| Author | Yoshio Taguma | Department of Nephrology, Sendai Shakaihoken Hospital |
| [ Summary ] | The number of patients treated with renal replacement therapy (RRT) reached 2,213 per million of the general population at the end of 2008. RRT is now widely recognized as the primary therapy for end-stage renal failure (ESRF). However, patients may not easily agree to spend the balance of their own lives on RRT. In addition, the number of elderly CKD patients has been growing in Japan, making it more commonly necessary to provide informed consent before initiation of RRT. Therefore, early referral to nephrologists is strongly recommended so they may evaluate and compensate for improper renal physiological and endocrine functions in the early stages of chronic renal failure. Vascular access operations in preparation for RRT are also important. Well-trained ESRF teams can support patients and their families to ameliorate worries related to the lifelong application of dialysis. Optimal pre-dialysis management can reduce the need for hospitalization to start dialysis. In conclusion, we should promote cooperation between diabetologists, cardiologists and general physicians to provide time for patient preparation, and to educate medical support staff members in providing informed consent to those patients who will begin receiving dialysis treatment. | |