Journal Article

Optimal predialysis care

Yvo W. J. Sijpkens, Noeleen C. Berkhout-Byrne and Ton J. Rabelink

in Clinical Kidney Journal

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 1, issue suppl_4, pages iv7-iv13
Published in print October 2008 | ISSN: 1753-0784
Published online October 2008 | e-ISSN: 1753-0792 | DOI: https://dx.doi.org/10.1093/ndtplus/sfn117

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Management of severe chronic kidney disease (CKD) involves dealing with medical, nursing and psychosocial problems and therefore warrants support from a multidisciplinary team. In the Kidney Disease Outcomes Quality Initiative (KDOQI) classification system of CKD, preparation for renal replacement therapy has been recommended in CKD stage 4, characterized by a reduction in the estimated glomerular filtration rate (GFR) of <30 ml/min. In this article we share our approach to perfecting predialysis care. Tools are given to make an estimation of the progression of kidney disease. Also the prevention and treatment of metabolic complications and cardiovascular risk management are summarized. Finally, the possibilities for dialysis but even more important, aiming for pre-emptive transplantation, are being discussed. Using a multidisciplinary integrated care approach predialysis care has come of age.

Keywords: chronic kidney disease; predialysis; pre-emptive transplantation

Journal Article.  4443 words.  Illustrated.

Subjects: Nephrology