April 19, 2014

Canadian Society of Nephrology 2014 clinical practice guideline for timing the initiation of chronic dialysis

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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.

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Chronic Kidney Disease, Clinical Practice Guidelines, Hemodialysis