JAMA Clinical Reviews

Dialysis for Chronic Kidney Failure

9 snips
Oct 2, 2024
Jennifer E. Flythe, MD, MPH, a dialysis expert from the University of North Carolina, joins Kristin L. Walter, MD, MS, JAMA's Deputy Editor. They delve into the crucial decision-making process behind choosing hemodialysis or peritoneal dialysis based on patient symptoms and preferences. The discussion highlights the ineffectiveness of statins and ICDs for cardiovascular prevention in dialysis patients. They also explore managing common symptoms like pruritus and depression, while shedding light on the high mortality risk within the first six months of treatment.
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INSIGHT

Kidney Failure Definition and Treatment

  • Kidney failure is defined as a glomerular filtration rate (GFR) under 15 mL/min/1.73 m^2.
  • Treatments include kidney transplant, hemodialysis, peritoneal dialysis, or supportive care.
INSIGHT

Uremia Symptoms

  • Common signs of uremia in chronic kidney failure include nausea, poor appetite, and fatigue.
  • Severe cases can present as seizures or coma.
ADVICE

Dialysis Initiation

  • There's no set GFR threshold for starting dialysis.
  • Base the decision on uremia, volume overload, lab results, and patient preferences.
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