Background: Patients with end-stage renal disease (ESRD)
receive renal replacement therapy (RRT) to improve their
survival and quality of life. Whereas RRT might be life-saving in
certain conditions, dialysis also is unphysiological and may have
life-threatening complications. Better understanding of
nephrologists’ decision making regarding the start of RRT would
assist further studies relating residual kidney function and signs
and symptoms at the start of dialysis therapy to prognosis.
Therefore, the aim of this study was to evaluate current opinions
on factors influence the decision of dialysis by performing a
survey of nephrologists in Qalubia Governorate, Egypt.
Methods: This cross-sectional observational study included
nephrologists from different hospitals, in Qalubia, Egypt. This
study included a web-based survey using the online tool
SurveyMonkey (SurveyMonkey.com). Approval of the Ethics
Committee in the Faculty of Medicine, Benha University was
taken before preceding the study. Results: Our results showed
that 84% of studied physicians would recommend dialysis
decision patients when eGFR decreased regardless any clinical
symptoms or signs out of them 71.4% recommend dialysis if
GFR decreased below 10 ml and others 28.6% recommend it
when GFR decreased below 15 ml. While only 30% of studied
physicians recommend initiation of dialysis if GFR increased
especially above 30 ml (60% out of them). Conclusions: That
nearly 84% of nephrologists based their decision to initiate
dialysis on eGFR alone. Initiatives designed to safely delay
dialysis through aggressive medical management could focus on modifiable factors that are the most important drivers of the decision to initiate dialysis |
