scholarly journals International variation in dialysis discontinuation in patients with advanced kidney disease

2020 ◽  
Vol 192 (35) ◽  
pp. E995-E1002
Author(s):  
Sarbjit V. Jassal ◽  
Maria Larkina ◽  
Kitty J. Jager ◽  
Fliss E.M. Murtagh ◽  
Ann M. O’Hare ◽  
...  
Keyword(s):  
Kidney Disease ◽  
International Variation ◽  
Dialysis Discontinuation

scholarly journals Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease

2019 ◽  
Vol 96 (4) ◽  
pp. 983-994 ◽  
Author(s):  
Natalia Alencar de Pinho ◽  
Adeera Levin ◽  
Masafumi Fukagawa ◽  
Wendy E. Hoy ◽  
Roberto Pecoits-Filho ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
International Variation ◽  
Prescription Patterns

International variation in the management of mineral bone disorder in patients with chronic kidney disease: Results from CKDopps

Bone ◽  
2019 ◽  
Vol 129 ◽  
pp. 115058
Author(s):  
Sophie Liabeuf ◽  
Keith McCullough ◽  
Eric W. Young ◽  
Ronald Pisoni ◽  
Jarcy Zee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
International Variation ◽  
Mineral Bone Disorder ◽  
Bone Disorder

scholarly journals MO1055JUDICIOUS DIALYSIS DISCONTINUATION IN CHRONIC KIDNEY DISEASE: LENDING MORE TIME TO ECONOMICALLY BURDENED PATIENTS IN DEVELOPING COUNTRY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sourabh Sharma ◽  
Neha Sharma ◽  
Kailash Sharma
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Developing Country ◽  
Serum Potassium ◽  
Baseline Serum ◽  
Ckd Stage ◽  
Dialysis Vintage ◽  
Dialysis Discontinuation

Abstract Background and Aims Chronic kidney disease (CKD) is important public health problem owing to its high prevalence, morbidity, mortality and socio-economic burden. Patients with end stage kidney disease need to be on kidney replacement therapy which significantly impacts livelihood. Annual average cost of treatment for patients on dialysis is reported to be USD 3151 in developing country like India. It’s quiet high given per capita income of USD 1670 Method One hundred fifty one CKD Stage 5D patients from Punjab and Rajasthan states, North India were studied in this cross-sectional study. Patients initiated on dialysis within 3 months or protein energy wasting (as per criteria proposed by ISRNM) were excluded. Asymptomatic willing patients, clinically stable for at least 3 months and with pre-dialysis serum Creatinine <6mg/dl, serum potassium <5mg/dl were given a trial for dialysis discontinuation after informed written consent. Biochemical and hemodynamic parameters were measured weekly for 4 weeks and later once monthly. Patients who developed uremic features or rapid rise in serum creatinine were restarted on dialysis. Results Fourteen (9.27%) asymptomatic patients with well controlled blood pressure were discontinued from dialysis. Out of them, thirteen patients were on hemodialysis and one on peritoneal dialysis. Twelve (85.71%) out of them were presumed chronic interstitial nephritis while two (14.28%) were autosomal dominant polycystic kidney disease. Mean age of patients was 52.5 years (SD ±18.14 years). Most patients (11/14) were on three or more anti-hypertensive. Mean dialysis vintage was 8.14 months (range 4-16 months). Most patients were non-compliant to dialysis (Mean frequency once in seven days). Two patients were on once in two week dialysis schedule. Mean 24 hour urine output (calculated over 1 week) was 1500ml. Mean baseline serum creatinine was 4.4 mg/dl (SD ±1.06 mg/dl). Mean pre-dialysis serum potassium was 4.5 mg/dl (SD ±0.42 mg/dl). Post-discontinuation serum creatinine levels has been outlined in figure 1. Mean distance of dialysis centre from residence was 83.43 Km (range 1-240 km). One patient need to be restarted on dialysis at fourth week of dialysis discontinuation. Rest patients remained symptom-free and tolerated well. Conclusion CKD Stage5D patients should be regularly screened for residual renal function. Recovery of renal function could be seen in some (<10%) cases. Dialysis discontinuation in these cases would decrease their financial and stress burden. However, these cases should be monitored closely and followed-up regularly

scholarly journals Conservative management for patients with chronic kidney disease refusing dialysis

2019 ◽  
Vol 41 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Manuel Carlos Martins Castro
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Family Physicians ◽  
Multidisciplinary Care ◽  
Contributing Factors ◽  
Local Conditions ◽  
Metabolic Alterations ◽  
Stage Renal Disease ◽  
End Stage ◽  
Dialysis Discontinuation

ABSTRACT Estimates suggest that 20-30% of the deaths of patients with chronic kidney disease with indication to undergo dialysis occur after refusal to continue dialysis, discontinuation of dialysis or inability to offer dialysis on account of local conditions. Contributing factors include aging, increased comorbidity associated with chronic kidney disease, and socioeconomic status. In several occasions nephrologists will intervene, but at times general practitioners or family physicians are on their own. Knowledge of the main etiologies of chronic kidney disease and the metabolic alterations and symptoms associated to end-stage renal disease is an important element in providing patients with good palliative care. This review aimed to familiarize members of multidisciplinary care teams with the metabolic alterations and symptoms arising from chronic kidney disease treated clinically without the aid of dialysis.

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