Stage 5-CKD under nephrology care: to dialyze or not to dialyze, that is the question

摘要: Appropriate timing of starting chronic dialysis in patients with advanced kidney disease (CKD) under nephrology care still is undefined. We systematically reviewed the most recent studies that have compared outcomes stage 5-CKD conservative versus substitutive treatment. Eleven studies, elderly patients, were identified. Results indicate no advantage over management terms survival, hospitalization or quality life. This information integrated a case report on middle-aged CKD patient followed our clinic who has remained for 15 years 5 despite severe disease. The diabetic woman underwent right nephrectomy 1994 because renal tuberculosis. In 1999, she commenced regular and, since 2000, when was 53 old, her estimated glomerular filtration rate (eGFR) been ≤15 ml/min/1.73 m(2). Over last decade, despite, several episodes acute injury and placement permanent percutaneous nephrostomy 2001, function remarkably stable, though severely impaired (eGFR 7.7-5.6 m(2)). Our systematic analysis literature this highlight need further not limited exclusively to verify efficacy non-dialysis treatment patients. Meanwhile, nephrologists may consider their intervention can safely prolong dialysis-free condition ESRD independently age.