Initiation Timing and Modality Option for Renal Replacement Therapy

  • Ping WenEmail author


The decision of the initiation timing of dialysis is not only due to the stage of chronic kidney disease but also due to the uremic symptoms. The uremic syndrome is a cluster of clinical and metabolic characteristics associated with fluid, electrolyte, hormonal, and metabolic abnormalities that progress as kidney function aggravates. Current KDOQI recommendations on indexes of the initiation of dialysis include Kt/V and malnutrition. If the symptoms (anorexia, nausea, vomiting, fatigability, and diminished sensorium) and signs (refractory pulmonary edema, metabolic acidosis, foot or wrist drop, and asterixis) of uremia are present, dialysis treatments are emergently indicated. Decisions on modalities of renal replacement therapy depend on not only physical conditions but also lifestyle and psychological conditions of patients.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Centre for Kidney DiseaseSecond Affiliated Hospital, Nanjing Medical UniversityNanjingChina

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