[Disadvantages and benefits of early initiation of dialysotherapy]

Along with dialysis therapy evolvement and its widespread availability, highly economically developed countries have shown a tendency to initiate dialysis therapy earlier. In the light of available data, this does not seem to be a tendency worth recommending. The key to improvement of quality of life and patient survival in chronic kidney disease (CKD) are: prophylactic measures of CKD, quicker diagnosis of kidney disease and early patient referral to the nephrologist. These measures permit for the delay of initiation of renal replacement therapy. When it becomes mandatory to start therapy, preemptive renal transplantation should be the choice especially for patients having a living related donor. When it is impossible start dialysis therapy based on peritoneal dialysis or hemodialysis.