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Starting dialysis at eGFR >5 ml/min per1.73 m(2): are we barking up the wrong tree?
Steven J Rosansky1, Martin W Durkin2
1Dorn Research Institute, Arnold School of Public Health, William Jennings Bryan Dorn Veterans Affairs Hospital, University of South Carolina, Columbia, South Carolina, USA.
Abstract:
Although the goal glomerular filtration rate (GFR) for chronic dialysis initiation is currently above 5 ml/min per 1.73 m(2), there is no convincing evidence that patients will benefit from this approach. With close follow-up of advanced chronic kidney disease patients, aiming to start dialysis at an estimated GFR (eGFR) less than 5 ml/min per 1.73 m(2) may result in the avoidance of potentially unnecessary end-of-life dialysis and could result in significant dialysis-free time for a large segment of the world's future dialysis population.
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