Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

The Sad Truth About Early Initiation of Dialysis in Elderly Patients

The Sad Truth About Early Initiation of Dialysis in Elderly Patients VIEWPOINT The Sad Truth About Early Initiation of Dialysis in Elderly Patients in elderly patients is not justified. This Viewpoint exam- Steven J. Rosansky, MD ines issues related to this trend and provides suggestions for management of elderly patients with advanced chronic ORTY YEARS AGO, AN ARTICLE IN JAMA ENTITLED “THE kidney disease (CKD). Sad Truth About Hemodialysis in Diabetic Nephropa- In 1997, published guidelines encouraged dialysis initia- thy” highlighted the poor outcomes for patients with tion for patients with poor nutrition in association with eGFR 1 2 Fdiabetes who were treated with dialysis. In the early levels of more than 10 mL/min per 1.73 m and in 2002, 2 4 1970s some patients with diabetes were not offered dialy- more than 15 mL/min per 1.73 m . Although decreased pro- sis because of expected poor outcomes. The problems of vi- tein intake and poor nutrition are associated with progres- sual deterioration and chronic fluid overload have been sive renal failure, there is no convincing evidence that di- largely resolved with laser therapy for diabetic retinopathy alysis improves nutrition (the most frequent justification for and vastly improved dialysis techniques. In a report pub- early initiation) and several publications report http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

The Sad Truth About Early Initiation of Dialysis in Elderly Patients

JAMA , Volume 307 (18) – May 9, 2012

Loading next page...
 
/lp/american-medical-association/the-sad-truth-about-early-initiation-of-dialysis-in-elderly-patients-vaMacI0VuH
Publisher
American Medical Association
Copyright
Copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2012.3522
pmid
22570459
Publisher site
See Article on Publisher Site

Abstract

VIEWPOINT The Sad Truth About Early Initiation of Dialysis in Elderly Patients in elderly patients is not justified. This Viewpoint exam- Steven J. Rosansky, MD ines issues related to this trend and provides suggestions for management of elderly patients with advanced chronic ORTY YEARS AGO, AN ARTICLE IN JAMA ENTITLED “THE kidney disease (CKD). Sad Truth About Hemodialysis in Diabetic Nephropa- In 1997, published guidelines encouraged dialysis initia- thy” highlighted the poor outcomes for patients with tion for patients with poor nutrition in association with eGFR 1 2 Fdiabetes who were treated with dialysis. In the early levels of more than 10 mL/min per 1.73 m and in 2002, 2 4 1970s some patients with diabetes were not offered dialy- more than 15 mL/min per 1.73 m . Although decreased pro- sis because of expected poor outcomes. The problems of vi- tein intake and poor nutrition are associated with progres- sual deterioration and chronic fluid overload have been sive renal failure, there is no convincing evidence that di- largely resolved with laser therapy for diabetic retinopathy alysis improves nutrition (the most frequent justification for and vastly improved dialysis techniques. In a report pub- early initiation) and several publications report

Journal

JAMAAmerican Medical Association

Published: May 9, 2012

References