PMID: 15384022Sep 24, 2004Paper

Multidisciplinary predialysis care and morbidity and mortality of patients on dialysis

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Marc GoldsteinPhilip McFarlane

Abstract

Multidisciplinary predialysis care results in fewer hospitalizations and more patients starting hemodialysis therapy with vascular access. Rigorous comparisons of the effect of different types of predialysis care on outcomes after the initiation of dialysis therapy are in their infancy. We hypothesized that outcomes after the initiation of dialysis therapy would be superior in patients receiving multidisciplinary predialysis care than in those receiving conventional care. All incident dialysis patients at our center who had received at least 3 months of specialist predialysis care were categorized according to whether they had attended the multidisciplinary Progressive Renal Disease Clinic (PRDC). Patients with a failed transplant, acute renal failure, or previous renal replacement therapy were excluded. We compared these groups at initiation and during 3 years of dialysis therapy. At the start of dialysis therapy, patient demographics and residual renal function were similar. PRDC patients were more likely to have a functioning access and be administered angiotensin-converting enzyme inhibitors, iron supplements, and bicarbonate therapy and had greater serum albumin and serum calcium levels. PRDC patients had fewer hospitaliza...Continue Reading

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