End-stage renal disease preceded by rapid declines in kidney function: a case series

BMC Nephrology

Research Article

Kirsten Johansen¹  Chi-yuan Hsu¹  Peter Lee¹ 

[1] Division of Nephrology, University of California, San Francisco, San Francisco, CA, USA;

关键词: Chronic Kidney Disease;    Glomerular Filtration Rate;    Kidney Function;    Acute Kidney Injury;    Rapid Decline;   

DOI  :  10.1186/1471-2369-12-5

 received in 2010-10-20, accepted in 2011-02-01,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundFew studies have defined alternate pathways by which chronic kidney disease (CKD) patients transition into end-stage renal disease (ESRD).MethodsWe studied all consecutive patients initiated on maintenance hemodialysis or peritoneal dialysis over several years at two dialysis units in Northern California. Rapid decline in kidney function was considered to have occurred if a patient was documented to have estimated GFR > 30 ml/min/1.73 m2 within three months prior to the initiation of chronic dialysis.ResultsWe found that 8 out of 105 incident chronic dialysis patients one dialysis unit (7.6%; 95% confidence interval 3.4-14.5%) and 9 out of 71 incident patients at another (12.7%, 95% CI 6.0%-22.7%) suffered rapid decline in kidney function that was the immediate precipitant for the need for permanent renal replacement therapy. All these patients started hemodialysis and all relied on catheters for vascular access. Documentation submitted to United States Renal Data System did not fully reflect the health status of these patients during their "pre-ESRD" period.ConclusionsA sizeable minority of ESRD cases are preceded by rapid declines in kidney function. The importance of these periods of rapid decline may have been under-appreciated in prior studies of the natural history of CKD and ESRD.

【 授权许可】

Unknown   
© Lee et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.