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Optimal predialysis care

Yvo W J Sijpkens1, Noeleen C Berkhout-Byrne1, Ton J Rabelink1

  • 1Department of Nephrology , Leiden University Medical Center , Leiden , The Netherlands.

NDT Plus
|May 19, 2015
PubMed

Insights

Effective predialysis care for severe chronic kidney disease (CKD) requires a multidisciplinary team approach. This includes managing complications and planning for renal replacement therapy or pre-emptive transplantation.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Public Health

Background:

  • Severe chronic kidney disease (CKD) management encompasses medical, nursing, and psychosocial aspects.
  • The Kidney Disease Outcomes Quality Initiative (KDOQI) recommends preparation for renal replacement therapy in CKD stage 4 (GFR <30 ml/min).

Purpose of the Study:

  • To outline an optimized approach to predialysis care for patients with severe CKD.
  • To provide tools for estimating kidney disease progression.
  • To summarize management strategies for complications and cardiovascular risk.

Main Methods:

  • Review and synthesis of current best practices in predialysis care.
  • Integration of multidisciplinary team support.
  • Discussion of treatment options including dialysis and pre-emptive transplantation.

Main Results:

  • A comprehensive, integrated care approach enhances predialysis patient management.
  • Tools for progression estimation and management of metabolic/cardiovascular issues are essential.
  • Planning for renal replacement therapy and transplantation is a key component.

Conclusions:

  • Predialysis care has matured into a distinct and vital component of CKD management.
  • A multidisciplinary, integrated approach is crucial for optimal patient outcomes.
  • Focusing on pre-emptive transplantation offers significant benefits.

Keywords:
chronic kidney diseasepre-emptive transplantationpredialysis

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