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10.1016/j.semnephrol.2016.12.008 http://scihub22266oqcxt.onion/10.1016/j.semnephrol.2016.12.008 C5407409!5407409!28410652     free     free     free Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Semin+Nephrol 2017 ; 37 (2): 181-93 Nephropedia Template TP {{tp|p=28410652|t=2017. Timing of Dialysis Initiation - What Has Changed Since IDEAL?|pdf=|usr=}}{{28410652}} gab.com Text Timing of Dialysis Initiation - What Has Changed Since IDEAL JO: Semin Nephrol http://www.kidney.de/pget.php?&tw=1&pmid=28410652 #FOAvip The optimal timing of initiation of maintenance dialysis in patients with end stage renal disease (ESRD) is currently unknown. This transition period is one of exceptionally high vulnerability for patients; annual mortality rates in stage 5 chronic kidney disease (CKD) through the first year of maintenance dialysis exceed 20%. The results of the Initiating Dialysis Early and Late (IDEAL) study, the only randomized trial to have tested the impact of dialysis initiation at two different levels of kidney function on outcomes, demonstrated no significant difference in survival or other patient-centered outcomes between treatment groups. These data have challenged the established paradigm of using estimates of glomerular filtration as the primary guide for initiation of maintenance dialysis and illustrate the compelling need for research to optimize the high risk transition period from CKD to ESRD. This article reviews the findings of the IDEAL study and summarizes the evolution of research findings, updated clinical practice guidelines, and trends in dialysis initiation practices in the United States in the 6 year since publication of the results from IDEAL. Complementary strategies to the use of eGFR to optimally time the initiation of maintenance dialysis and potentially improve patient-centered outcomes are also considered. Twit Text FOAVip Timing of Dialysis Initiation - What Has Changed Since IDEAL ????Semin Nephrol http://www.kidney.de/pget.php?&tw=1&pmid=28410652 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=28410652 #FOAvip English Wikipedia <ref>{{Cite pmid|28410652}}</ref> Timing of Dialysis Initiation - What Has Changed Since IDEAL? #MMPMID28410652 Rivara MB; Mehrotra R Semin Nephrol 2017[Mar]; 37 (2): 181-93 PMID28410652show ga The optimal timing of initiation of maintenance dialysis in patients with end stage renal disease (ESRD) is currently unknown. This transition period is one of exceptionally high vulnerability for patients; annual mortality rates in stage 5 chronic kidney disease (CKD) through the first year of maintenance dialysis exceed 20%. The results of the Initiating Dialysis Early and Late (IDEAL) study, the only randomized trial to have tested the impact of dialysis initiation at two different levels of kidney function on outcomes, demonstrated no significant difference in survival or other patient-centered outcomes between treatment groups. These data have challenged the established paradigm of using estimates of glomerular filtration as the primary guide for initiation of maintenance dialysis and illustrate the compelling need for research to optimize the high risk transition period from CKD to ESRD. This article reviews the findings of the IDEAL study and summarizes the evolution of research findings, updated clinical practice guidelines, and trends in dialysis initiation practices in the United States in the 6 year since publication of the results from IDEAL. Complementary strategies to the use of eGFR to optimally time the initiation of maintenance dialysis and potentially improve patient-centered outcomes are also considered. äTiming of Dialysis Initiation - What Has Changed Since IDEAL?(epmc).pdf DeepDyve Pubget Overpricing