Initiation And Incremental Dialysis

Initiation of dialysis and incremental dialysis Wong KW

Initiation of dialysis ,[object Object],[object Object],[object Object],[object Object]

Goals of dialysis ,[object Object],[object Object],[object Object],[object Object]

Complications That May Prompt Initiation of Kidney Replacement Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

When to initiate? ,[object Object],[object Object],[object Object]

When to initiate? ,[object Object],[object Object]

What did the European Nephrologists think? ,[object Object],[object Object],[object Object]

KDOQI Guidelines (opinion) ,[object Object],[object Object],[object Object],[object Object],[object Object]

KDOQI Guidelines (opinion) ,[object Object]

KDOQI - second update of the Clinical Practice Guidelines (CPGs) and Clinical Practice Recommendations (CPRs) ,[object Object],[object Object]

Nephrol Dial Transplant (2002) 17 [Suppl 7 ]: 7 -1 5 ,[object Object],[object Object],[object Object],[object Object],[object Object]

Nephrol Dial Transplant (2002) 17 [Suppl 7 ]: 7 -1 5 ,[object Object],[object Object]

Nephrol Dial Transplant (2005) 20 [Suppl 9] ,[object Object],[object Object]

CARI Guidelines (September 2004) No recommendations possible based on Level I or II evidence ,[object Object],[object Object]

CARI Guidelines (September 2004) ,[object Object],[object Object]

CARI guidelines (September 2004) ,[object Object],[object Object]

Canadian guidelines ( J Am Soc Nephrol 10: S287 -S 321, 1999) ,[object Object],[object Object],[object Object]

Malaysian CPG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Postulate and practice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What is the evidence? ,[object Object],[object Object],[object Object]

Nutrition and renal failure ,[object Object],[object Object]

Nutrition and residual renal function ,[object Object],[object Object],[object Object],[object Object]

Nutrition and RRF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Nutrition ,[object Object],[object Object],[object Object],[object Object]

Malnutrition at initiation of dialysis

Malnutrition at initiation of dialysis ,[object Object],[object Object]

Early initiation - believers ,[object Object]

Bonomini et al, 1985 ,[object Object],[object Object]

Early initiation - believers ,[object Object],[object Object],[object Object]

Early initiation - believers ,[object Object],[object Object],[object Object],[object Object]

Early initiation ,[object Object],[object Object],[object Object]

Early initiation - skeptics - lead time bias ,[object Object]

Early initiation - skeptics - lead time bias ,[object Object],[object Object],[object Object],[object Object],[object Object]

Early initiation - skeptics - QOL ,[object Object],[object Object]

Early initiation does not prolong survival? ,[object Object],[object Object],[object Object],[object Object]

Early initiation of dialysis increases risk of mortality? ,[object Object],[object Object],[object Object],[object Object],[object Object]

The problem of measuring residual renal function(RRF) ,[object Object],[object Object],[object Object],[object Object],[object Object]

The problem of measuring residual renal function(RRF) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Definite answer? IDEAL TRIAL ,[object Object]

Incremental dialysis? ,[object Object],[object Object]

Incremental dialysis ,[object Object],[object Object],[object Object],[object Object]

Should We Treat Patients with Incremental Dialysis Prescriptions? ,[object Object]

Incremental dialysis - Bonomini et al ,[object Object],[object Object],[object Object],[object Object]

Incremental dialysis - Williams et al ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Incremental dialysis - Devecchi et al ,[object Object],[object Object],[object Object]

Incremental dialysis - Foggensteiner et al ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Incremental dialysis - Keshaviah et al ,[object Object],[object Object],[object Object]

The Wake Forest Experience - Burkart et al ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Incremental dialysis ,[object Object],[object Object]

Some Considerations for Incremental Dialysis ,[object Object],[object Object],[object Object],[object Object],[object Object]

Potential Obstacles ,[object Object],[object Object],[object Object],[object Object]

Risk of incremental dialysis? ,[object Object],[object Object],[object Object],[object Object]

Incremental dialysis advantages and disadvantages ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Alternative to early start of dialysis? ,[object Object],[object Object],[object Object],[object Object]

Can renal replacement be deferred by a supplemented very low-protein diet? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Initiation And Incremental Dialysis

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Initiation And Incremental Dialysis