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Nephrol Dial Transplant (2002) 17: 10-11
© 2002 European Renal Association-European Dialysis and Transplant Association

SECTION I: Measurement of renal function, when to refer and when to start dialysis

I.3 When to start dialysis

Abstract

Guideline I.3

A. Dialysis should be instituted whenever the GFR is <15 ml/min and there is one or more of the following: symptoms or signs of uraemia, inability to control hydration status or blood pressure, or a progressive deterioration in nutritional status. In any case, dialysis should be started before the GFR has fallen to 6 ml/min/1.73 m2, even if optimal pre-dialysis care has been provided and there are no symptoms.

B. High-risk patients e.g. diabetics may benefit from an earlier start.

(Evidence level: C)

C. To ensure that dialysis is started before the GFR is <6 ml/min, clinics should aim to start at 8–10 ml/min.

(Evidence level: C)


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