Canadian Society of Nephrology 2014 clinical practice guideline for timing the initiation of chronic dialysis
The CSN 2014 clinical practice guideline for timing the initiation of chronic dialysis makes the following main points.
Early initiation of dialysis does not improve survival, quality of life or hospital admission rates compared with late or deferred initiation of dialysis. As a result, they recommend an “intent-to-defer” strategy, whereby patients with an eGFR < 15 mL/ min per 1.73 m2 are closely monitored, with dialysis initiated when symptoms develop or eGFR is ≤ 6 mL/min per 1.73m2.
- A Randomized, Controlled Trial of Early versus Late Initiation of Dialysis
- Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients
- The Impact of Timing of Dialysis Initiation on Mortality in Patients with Peritoneal Dialysis