演題情報

学会・委員会企画

開催回
第56回・2011年・横浜
 

When Should RRT be Initiated in Stage 5 CKD Patients?

演題番号 : GI-8-1

Bruce Cooper:1

1:Department of Renal Medicine, Royal North Shore Hospital, Australia

 

Ten years ago international guidelines around the world were recommending the early initiation of dialysis with the aim of reducing mortality, morbidity and cost in patients being treated for chronic kidney disease. Since this time there has been a major uptake of early initiation of dialysis around the world. However, more recent reviews of dialysis registries and cohort studies have been published indicating that early initiation of dialysis may be harmful and that dialysis should be delayed. The recently published IDEAL trial, a large randomised controlled trial of dialysis initiation, has now shown that clinical outcomes, including survival, are similar between patients in whom dialysis is initiated early and those for whom dialysis is electively delayed. The results also show that with careful clinical management, dialysis may be delayed until either the GFR drops below 7.0 ml per minute or more traditional clinical indicators for the initiation of dialysis are present. In this talk I will be discussing the important findings of this trial and its clinical practice implications in regards to when renal replacement therapy should be initiated for patients with chronic kidney disease.

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