Stage IV Chronic Kidney Disease

To the Editor: In the review of stage IV chronic kidney disease by Abboud and Henrich (Jan. 7 issue), 1 there is an omission that, as a practicing physician and kidney-transplant recipient, I would like to point out. The authors suggest that patients be “informed about methods of renal-replacement therapy” and specify that upper-extremity veins should be protected in case vascular access is needed for hemodialysis. However, the authors should also have suggested that appropriate patients be encouraged to identify live kidney donors early on, in order to plan for possible transplantation before or shortly after the onset of end-stage renal . . .