Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis?
Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis? Until 1996, no guidelines existed for the initiation of dialysis in patients with progressive renal failure. The publication of the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines has g...
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| Veröffentlicht in: | Kidney international 2000-10, Vol.58 (4), p.1381-1388 |
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| description | Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis? Until 1996, no guidelines existed for the initiation of dialysis in patients with progressive renal failure. The publication of the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines has generated a debate on the management of advanced renal failure and the role of low-protein diets (LPDs). We performed a review of the literature to identify articles on the initiation of dialysis and LPDs, particularly those since 1996. Delayed referral of patients is widespread in both the United States and Europe, and almost 25% of patients are started on dialysis at a glomerular filtration rate (GFR) of |
| doi_str_mv | 10.1046/j.1523-1755.2000.00300.x |
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Until 1996, no guidelines existed for the initiation of dialysis in patients with progressive renal failure. The publication of the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines has generated a debate on the management of advanced renal failure and the role of low-protein diets (LPDs). We performed a review of the literature to identify articles on the initiation of dialysis and LPDs, particularly those since 1996. Delayed referral of patients is widespread in both the United States and Europe, and almost 25% of patients are started on dialysis at a glomerular filtration rate (GFR) of <5mL/min/1.73m2. There is a high prevalence of malnutrition at the time of first dialysis, which progressively improves upon initiation of dialysis. There is no evidence regarding the efficacy or safety of LPDs in nondiabetic patients younger than 70 years old [approximately 40% of U.S. incident end-stage renal disease (ESRD) patients] and in diabetics with GFR <25mL/min/1.73m2 (>40% of incident U.S. ESRD). In nondiabetics who are younger than 70 years old, adherence to LPD for four to five years can be estimated to result in a delay in dialysis by 6 to 11 months. However, suboptimal energy intake is widespread in advanced renal failure, which declines further upon institution of LPD. Even nutritionally sound patients develop subclinical nutritional decline despite intense counseling. There are no data on the efficacy or safety of LPD in subgroups that constitute approximately 80% of incident ESRD patients. Concerns still exist regarding their nutritional safety in the remainder. Initiation of dialysis results in improved nutritional status and should be considered in a timely fashion.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1046/j.1523-1755.2000.00300.x</identifier><identifier>PMID: 11012873</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; CAPD ; Diet, Protein-Restricted ; Emergency and intensive care: renal failure. Dialysis management ; end-stage renal disease ; hemodialysis ; Humans ; Intensive care medicine ; kidney dialysis ; Kidney Failure, Chronic - diet therapy ; malnutrition ; Medical sciences ; nutrition ; progressive renal disease ; Renal Dialysis ; Time Factors</subject><ispartof>Kidney international, 2000-10, Vol.58 (4), p.1381-1388</ispartof><rights>2000 International Society of Nephrology</rights><rights>2000 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Oct 2000</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c564t-932953fd9b4024714abdff6e2f712e1fa786d727ea7bf4498334bb54b0959d3</citedby><cites>FETCH-LOGICAL-c564t-932953fd9b4024714abdff6e2f712e1fa786d727ea7bf4498334bb54b0959d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/210105392?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1510578$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11012873$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mehrotra, Rajnish</creatorcontrib><creatorcontrib>Nolph, Karl D.</creatorcontrib><title>Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis?</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis? Until 1996, no guidelines existed for the initiation of dialysis in patients with progressive renal failure. The publication of the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines has generated a debate on the management of advanced renal failure and the role of low-protein diets (LPDs). We performed a review of the literature to identify articles on the initiation of dialysis and LPDs, particularly those since 1996. Delayed referral of patients is widespread in both the United States and Europe, and almost 25% of patients are started on dialysis at a glomerular filtration rate (GFR) of <5mL/min/1.73m2. There is a high prevalence of malnutrition at the time of first dialysis, which progressively improves upon initiation of dialysis. There is no evidence regarding the efficacy or safety of LPDs in nondiabetic patients younger than 70 years old [approximately 40% of U.S. incident end-stage renal disease (ESRD) patients] and in diabetics with GFR <25mL/min/1.73m2 (>40% of incident U.S. ESRD). In nondiabetics who are younger than 70 years old, adherence to LPD for four to five years can be estimated to result in a delay in dialysis by 6 to 11 months. However, suboptimal energy intake is widespread in advanced renal failure, which declines further upon institution of LPD. Even nutritionally sound patients develop subclinical nutritional decline despite intense counseling. There are no data on the efficacy or safety of LPD in subgroups that constitute approximately 80% of incident ESRD patients. Concerns still exist regarding their nutritional safety in the remainder. Initiation of dialysis results in improved nutritional status and should be considered in a timely fashion.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>CAPD</subject><subject>Diet, Protein-Restricted</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>end-stage renal disease</subject><subject>hemodialysis</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>kidney dialysis</subject><subject>Kidney Failure, Chronic - diet therapy</subject><subject>malnutrition</subject><subject>Medical sciences</subject><subject>nutrition</subject><subject>progressive renal disease</subject><subject>Renal Dialysis</subject><subject>Time Factors</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU1v1DAQhi0EokvhJ4AshHrL4s845oJoxZe0Egd64GY58VjyKomL7ZTuv8fprlqJCxf7MM-M3nkGIUzJlhLRvt9vqWS8oUrKLSOEbAnh9b17gjYPhadoQ0gnGyZ5d4Ze5LyvYKc5eY7OKCWUdYpv0K_rBLZMMBccPbbu1s4DOJxgtiP2NoxLgg94F_80NykWCDN2AUrGMeESJhgPOMyhBFtCnNcJLtjxkEP--BI983bM8Or0n6OfXz5fX31rdj--fr_6tGsG2YrSaM605N7pXhAmFBW2d963wLyiDKi3qmudYgqs6r0QuuNc9L0UPdFSO36OLo5Ta7rfC-RippAHGEc7Q1yyUYwT3Wpawbf_gPu4pLpkNqzKIJJrVqHuCA0p5pzAm5sUJpsOhhKzijd7s_o1q1-zijf34s1dbX1zmr_0E7jHxpPpCrw7ATYPdvSpig75kZM1g-oq9vqIzbZU9Q_1ujpV9xEvj3WoTm8DJJOHAOvNQoKhGBfD_8P-BU9_qjk</recordid><startdate>20001001</startdate><enddate>20001001</enddate><creator>Mehrotra, Rajnish</creator><creator>Nolph, Karl D.</creator><general>Elsevier Inc</general><general>Nature Publishing</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20001001</creationdate><title>Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis?</title><author>Mehrotra, Rajnish ; Nolph, Karl D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564t-932953fd9b4024714abdff6e2f712e1fa786d727ea7bf4498334bb54b0959d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>CAPD</topic><topic>Diet, Protein-Restricted</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>end-stage renal disease</topic><topic>hemodialysis</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>kidney dialysis</topic><topic>Kidney Failure, Chronic - diet therapy</topic><topic>malnutrition</topic><topic>Medical sciences</topic><topic>nutrition</topic><topic>progressive renal disease</topic><topic>Renal Dialysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mehrotra, Rajnish</creatorcontrib><creatorcontrib>Nolph, Karl D.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mehrotra, Rajnish</au><au>Nolph, Karl D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis?</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2000-10-01</date><risdate>2000</risdate><volume>58</volume><issue>4</issue><spage>1381</spage><epage>1388</epage><pages>1381-1388</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis? Until 1996, no guidelines existed for the initiation of dialysis in patients with progressive renal failure. The publication of the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines has generated a debate on the management of advanced renal failure and the role of low-protein diets (LPDs). We performed a review of the literature to identify articles on the initiation of dialysis and LPDs, particularly those since 1996. Delayed referral of patients is widespread in both the United States and Europe, and almost 25% of patients are started on dialysis at a glomerular filtration rate (GFR) of <5mL/min/1.73m2. There is a high prevalence of malnutrition at the time of first dialysis, which progressively improves upon initiation of dialysis. There is no evidence regarding the efficacy or safety of LPDs in nondiabetic patients younger than 70 years old [approximately 40% of U.S. incident end-stage renal disease (ESRD) patients] and in diabetics with GFR <25mL/min/1.73m2 (>40% of incident U.S. ESRD). In nondiabetics who are younger than 70 years old, adherence to LPD for four to five years can be estimated to result in a delay in dialysis by 6 to 11 months. However, suboptimal energy intake is widespread in advanced renal failure, which declines further upon institution of LPD. Even nutritionally sound patients develop subclinical nutritional decline despite intense counseling. There are no data on the efficacy or safety of LPD in subgroups that constitute approximately 80% of incident ESRD patients. Concerns still exist regarding their nutritional safety in the remainder. Initiation of dialysis results in improved nutritional status and should be considered in a timely fashion.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11012873</pmid><doi>10.1046/j.1523-1755.2000.00300.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences CAPD Diet, Protein-Restricted Emergency and intensive care: renal failure. Dialysis management end-stage renal disease hemodialysis Humans Intensive care medicine kidney dialysis Kidney Failure, Chronic - diet therapy malnutrition Medical sciences nutrition progressive renal disease Renal Dialysis Time Factors |
| title | Treatment of advanced renal failure: Low-protein diets or timely initiation of dialysis? |
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