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2015 ; 8
(3
): 271-7
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The first year on haemodialysis: a critical transition
#MMPMID26034587
Broers NJ
; Cuijpers AC
; van der Sande FM
; Leunissen KM
; Kooman JP
Clin Kidney J
2015[Jun]; 8
(3
): 271-7
PMID26034587
show ga
The first year following the start of haemodialysis (HD) is associated with
increased mortality, especially during the first 90-120 days after the start of
dialysis. Whereas the start of dialysis has important effects on the internal
environment of the patient, there are relatively few studies assessing changes in
phenotype and underlying mechanisms during the transition period following
pre-dialysis to dialysis care, although more insight into these parameters is of
importance in unravelling the causes of this increased early mortality. In this
review, changes in cardiovascular, nutritional and inflammatory parameters during
the first year of HD, as well as changes in physical and functional performance
are discussed. Treatment-related factors that might contribute to these changes
include vascular access and pre-dialysis care, dialysate prescription and the
insufficient correction of the internal environment by current dialysis
techniques. Patient-related factors include the ongoing loss of residual renal
function and the progression of comorbid disease. Identifying phenotypic changes
and targeting risk patterns might improve outcome during the transition period.
Given the scarcity of data on this subject, more research is needed.
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