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Nephrology Dialysis Transplantation 2006 21(Supplement 2):ii20-ii24; doi:10.1093/ndt/gfl139
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

When to start dialysis?

C. E. Douma1 and W. Smit2

1 Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands and 2 Department of Nephrology, Academic Medical Center, University of Amsterdam, The Netherlands

Correspondence and offprint requests to: C. E. Douma MD, PhD, Department of Nephrology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.Email: ce.douma{at}vumc.nl

In an attempt to decrease mortality in dialysis patients, the care for end-stage renal disease patients has been a focus of nephrologists for many years. Good pre-dialysis care has been found to improve mortality numbers in several studies. However, it is still not exactly clear, when the best moment has arrived to start renal replacement therapy.

By illustrating two totally different patient cases the effect of outcome and quality of life are discussed—demonstrating on the one hand the role of clinical parameters, and on the other hand the influence of biochemical parameters.

Keywords: biochemical parameters; clinical parameters; Cockcroft–Gault formula; dialysis initiation; MDRD formula


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