| [ Summary ] |
The 1992 Ministry of Health and Welfare criteria for chronic dialysis initiation were defined by scores of kidney function, clinical manifestations, and daily activity. High serum creatinine levels of 8.0 mg/dL or over are often regarded as indicators of terminal kidney failure. Patients with stage 5 CKD, or eGFR < 15mL/min/1.73 m2, are classified as end-stage kidney disease (ESKD) patients according to the definition of the KDIGO (Kidney Disease : Improving Global Outcomes) study. These patients are considered candidates for renal replacement therapy such as chronic dialysis therapy. Serum creatinine levels in CKD stage 5 patients are approximately 4.0mg/dL or higher, per the CKD practice guidelines of 2012 established by the Japanese Society of Nephrology. Uremic symptoms are analyzed in relation to the speed of GFR decline, primary kidney disease, and co-morbid conditions other than the degree of GFR. A recent IDEAL study exhibited that prognoses after initiating dialysis are not statistically different between patients who start dialysis early versus those who start later. |