Review article: Biomedical intelligence
Vol. 142 No. 4748 (2012)
A road map for patients with imminent end-stage renal disease
- Felix Burkhalter
- Jürg Steiger
- Michael Dickenmann
Chronic kidney disease (CKD) represents a relevant medical and financial burden. More than 5% of the population suffers from CKD. There should be an accurately timed evaluation of best renal replacement therapy in all patients with CKD. Kidney transplantation is the treatment of choice for patients with end-stage renal disease. Living donated kidney transplantation offers the best results and should be evaluated in every patient suitable for transplantation. Haemodialysis and peritoneal dialysis are equally effective treatment options in patients not suitable for transplantation and should be individually evaluated. Conservative treatment, avoiding a dialysis treatment, can also be an option. Close cooperation of the general practitioner with a nephrologist improves patient management and helps to lower costs.
Summary and conclusions
There should be an accurately timed evaluation of best renal replacement therapy in all patients with CKD. However conservative treatment can also be an option. Kidney transplantation is the treatment of choice for patients with end-stage renal disease. Living donated kidney transplantation offers the best results and should be evaluated in every patient suitable for transplantation. Haemodialysis and peritoneal dialysis are equally effective treatment options in patients not suitable for transplantation or to bridge time to transplantation and should be individually evaluated. Close cooperation of the general practitioner with a nephrologist improves patient management and helps to lower costs.
- Hallan SI, Coresh J, Astor BC, Asberg A, Powe NR, Romundstad S, et al. International comparison of the relationship of chronic kidney disease prevalence and ESRD risk. J Am Soc Nephrol. 2006;17(8):2275–84.
- Glynn LG, Anderson J, Reddan D, Murphy AW. Chronic kidney disease in general practice: prevalence, diagnosis, and standards of care. Ir Med J. 2009;102(9):285–8.
- United States Renal Data System, USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, 2010. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD; 2010 Jan 1.
- Lameire N, Jager K, Van BW, de BD, Vanholder R. Chronic kidney disease: a European perspective. Kidney Int Suppl. 2005;(99):S30–S38.
- Salonen T, Reina T, Oksa H, Sintonen H, Pasternack A. Cost analysis of renal replacement therapies in Finland. Am J Kidney Dis. 2003;42(6):1228–38.
- Villa G, Rodriguez-Carmona A, Fernandez-Ortiz L, Cuervo J, Rebollo P, Otero A, et al. Cost analysis of the Spanish renal replacement therapy programme. Nephrol Dial Transplant. 2011;26(11):3709–14.
- Levey AS, Schoolwerth AC, Burrows NR, Williams DE, Stith KR, McClellan W. Comprehensive public health strategies for preventing the development, progression, and complications of CKD: report of an expert panel convened by the Centers for Disease Control and Prevention. Am J Kidney Dis. 2009;53(3):522–35.
- Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012;379(9811):165–80.
- Pereira BJ. Optimization of pre-ESRD care: the key to improved dialysis outcomes. Kidney Int. 2000;57(1):351–65.
- Chan MR, Dall AT, Fletcher KE, Lu N, Trivedi H. Outcomes in patients with chronic kidney disease referred late to nephrologists: a meta-analysis. Am J Med. 2007;120(12):1063–70.
- Khan SS, Xue JL, Kazmi WH, Gilbertson DT, Obrador GT, Pereira BJ, et al. Does predialysis nephrology care influence patient survival after initiation of dialysis? Kidney Int. 2005;67(3):1038–46.
- Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130(6):461–70.
- Mitch WE, Walser M, Buffington GA, Lemann J, Jr. A simple method of estimating progression of chronic renal failure. Lancet. 1976;2(7999):1326–8.
- Clinical practice guidelines for hemodialysis adequacy, update 2006. Am J Kidney Dis. 2006;48(Suppl 1):S2–90.
- Couchoud C, Labeeuw M, Moranne O, Allot V, Esnault V, Frimat L, et al. A clinical score to predict 6-month prognosis in elderly patients starting dialysis for end-stage renal disease. Nephrol Dial Transplant. 2009;24(5):1553–61.
- Berger JR, Hedayati SS. Renal Replacement Therapy in the Elderly Population. Clin J Am Soc Nephrol. 2012 Apr 19.
- Murtagh FE, Marsh JE, Donohoe P, Ekbal NJ, Sheerin NS, Harris FE. Dialysis or not? A comparative survival study of patients over 75 years with chronic kidney disease stage 5. Nephrol Dial Transplant. 2007;22(7):1955–62.
- Carson RC, Juszczak M, Davenport A, Burns A. Is maximum conservative management an equivalent treatment option to dialysis for elderly patients with significant comorbid disease? Clin J Am Soc Nephrol. 2009;4(10):1611–9.
- Jassal SV, Chiu E, Hladunewich M. Loss of independence in patients starting dialysis at 80 years of age or older. N Engl J Med. 2009;361(16):1612–3.
- 2002 Albert Lasker Award for Clinical Medical Research. J Am Soc Nephrol. 2002;13(12):3027–30.
- European Renal Association EDaTA. Annual Report. 2007 Jan 1.
- Breidthardt T, Moser-Bucher CN, Praehauser C, Garzoni D, Bachler K, Steiger J, et al. Morbidity and mortality on chronic haemodialysis: a 10-year Swiss single centre analysis. Swiss Med Wkly. 2011;141:w13150.
- Kooistra M. Frequent prolonged home haemodialysis: three old concepts, one modern solution. Nephrol Dial Transplant. 2012;18:16–9.
- Vonesh EF, Snyder JJ, Foley RN, Collins AJ. Mortality studies comparing peritoneal dialysis and hemodialysis: what do they tell us? Kidney Int Suppl. 2006;(103):S3–11.
- Jain AK, Blake P, Cordy P, Garg AX. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol. 2012;23(3):533–44.
- Brown EA, Johansson L, Farrington K, Gallagher H, Sensky T, Gordon F, et al. Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients. Nephrol Dial Transplant. 2010;25(11):3755–63.
- Aslam N, Bernardini J, Fried L, Burr R, Piraino B. Comparison of infectious complications between incident hemodialysis and peritoneal dialysis patients. Clin J Am Soc Nephrol. 2006;1(6):1226–33.
- Hoen B, Paul-Dauphin A, Hestin D, Kessler M. EPIBACDIAL: a multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients. J Am Soc Nephrol. 1998;9(5):869–76.
- Descoeudres B, Koller MT, Garzoni D, Wolff T, Steiger J, Schaub S, Mayr M. Contribution of early failure to outcome on peritoneal dialysis. Perit Dial Int. 2008;28(3):259–67.
- CTS. CTS K15108E-0212.[electronic mail system]. 212 Apr 22.
- Evaluation of potential renal transplantation. In: Danovitch G, editor. Handbook of Kidney Transplantation. 4th edition ed. Philadelphia: Lippincott Williams and Wilkins; 2005.
- Vajdic CM, van Leeuwen MT. Cancer incidence and risk factors after solid organ transplantation. Int J Cancer. 2009;125(8):1747–54.
- Nevins TE, Thomas W. Quantitative patterns of azathioprine adherence after renal transplantation. Transplantation. 2009;87(5):711–8.
- Guild WR, Harrison JH, Merrill JP, Murray J. Successful homotransplantation of the kidney in an identical twin. Trans Am Clin Climatol Assoc. 1955;67:167–73.
- Murray JE. Ronald Lee Herrick Memorial: June 15, 1931–December 27, 2010. Am J Transplant. 2011;11(3):419.
- Swisstransplant Jahresbericht 2011. 01.01.2012: 2012.
- Papalois VE, Moss A, Gillingham KJ, Sutherland DE, Matas AJ, Humar A. Pre-emptive transplants for patients with renal failure: an argument against waiting until dialysis. Transplantation. 2000;70(4):625–31.
- Thiel GT, Nolte C, Tsinalis D. Prospective Swiss cohort study of living-kidney donors: study protocol. BMJ Open. 2011;1(2):e000202.
- Thiel GT, Nolte C, Tsinalis D. The Swiss Organ Living Donor Health Registry (SOL-DHR). Ther Umsch. 2005;62(7):449–57.
- Oettl T, Halter J, Bachmann A, Guerke L, Infanti L, Oertli D, et al. ABO blood group-incompatible living donor kidney transplantation: a prospective, single-centre analysis including serial protocol biopsies. Nephrol Dial Transplant. 2009;24(1):298–303.
- Oettl T, Zuliani E, Gaspert A, Hopfer H, Dickenmann M, Fehr T. Late steroid withdrawal after ABO blood group-incompatible living donor kidney transplantation: high rate of mild cellular rejection. Transplantation. 2010;89(6):702–6.
- Gentry SE, Montgomery RA, Segev DL. Kidney paired donation: fundamentals, limitations, and expansions. Am J Kidney Dis. 2011;57(1):144–51.
- Immer FF. What does the practicing doctor need to know about the transplantation law and its effects? Ther Umsch. 2011;68(12):673–7.
- National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classifi cation, and stratifi cation. Am J Kidney Dis. 2002;39(2 Suppl):S1–S266.
- Levey AS, Beto JA, Coronado BE, Eknoyan G, Foley RN, Kasiske BL, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on Cardiovascular Disease. Am J Kidney Dis. 1998;32(5):853–906.
- Jofre R, Lopez-Gomez JM, Moreno F, Sanz-Guajardo D, Valderrabano F. Changes in quality of life after renal transplantation. Am J Kidney Dis. 1998;32(1):93–100.
- Van Gelder F, Manyalich1 M, Nanni Costa A, Paez G. 2009 International donation and transplantation activity. IRODaT preliminary data. Organs, Tissues and Cells. 2010;13:5–8.