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Initiation of dialysis

R M Hakim, J M Lazarus

    Journal of the American Society of Nephrology : JASN
    |November 1, 1995
    PubMed
    Summary
    This summary is machine-generated.

    Objective criteria for initiating dialysis, focusing on malnutrition indicators like weight loss and low serum albumin, can improve patient outcomes. Early dialysis initiation and nephrologist referral are crucial for better survival and reduced costs.

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    Clinical nephrology·2002

    Area of Science:

    • Nephrology
    • Clinical Nutrition

    Background:

    • Dialysis initiation decisions often rely on subjective uremic symptoms.
    • Malnutrition at dialysis start predicts higher mortality risk.
    • There's a need for objective criteria to guide dialysis initiation.

    Discussion:

    • Examines protein restriction and its effect on spontaneous dietary intake in progressive renal disease.
    • Proposes objective malnutrition markers: weight loss, low serum albumin (<4.0 g/dL), low transferrin (<200 mg/dL), and low protein intake (<0.8 g/kg/day).
    • Highlights benefits of early dialysis initiation and nephrologist referral for improved morbidity, mortality, and cost-effectiveness.

    Key Insights:

    • Malnutrition indices can serve as objective criteria for dialysis initiation.
    • Early dialysis commencement is associated with better patient outcomes.

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  • Timely nephrologist referral improves patient health and reduces healthcare costs.

    • Outlook:

    • Further research into refining objective markers for dialysis initiation.
    • Integrating nutritional assessment into routine renal disease management.
    • Developing comprehensive patient preparation protocols for dialysis.