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Nephrol Dial Transplant (1999) 14: 2822-2823
© 1999 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Pre-emptive CAPD—what are the arguments?

Max Dratwa

Clinique de Néphrologie-Dialyse, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium

Correspondence and offprint requests to: Max Dratwa, Clinique de Néphrologie-Dialyse, CHU Brugmann, Université Libre de Bruxelles, 4 Place Van Gehuchten, B-1020 Brussels, Belgium.

`It's no good running fast, what counts is not starting late-' ... and with a belly full of dialysate.

Introduction

Despite improvements in dialytic therapy and hormonal replacement, patients with end-stage renal disease (ESRD) still display high morbidity and mortality. A variety of factors have been implicated. The burden of co-morbid conditions (cardiovascular disease, hypertension, anaemia, malnutrition, etc.) with which patients reach ESRD has great importance and requires interventions certainly several years before renal replacement therapy (RRT) is started. Factors more readily amenable to intervention by nephrologists include dialysis dose, pre-ESRD care, and timely initiation of dialysis. Improvement of dialysis adequacy by increasing the dose delivered by both haemodialysis (HD) and peritoneal dialysis (PD) has been a consistent trend of the past decade. Early referral to optimize pre-ESRD care . . . [Full Text of this Article]

When to start dialysis?

Which modality of dialysis to select?

What are the advantages?

Conclusion

References


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