LE “EVIDENZE” NEFROLOGICHE · Recommendation No. 5* If appropriate, forgo (withhold initiating...
Transcript of LE “EVIDENZE” NEFROLOGICHE · Recommendation No. 5* If appropriate, forgo (withhold initiating...
![Page 2: LE “EVIDENZE” NEFROLOGICHE · Recommendation No. 5* If appropriate, forgo (withhold initiating or withdraw ongoing) dialysis for patients with AKI CKD or ESRD in certain, well-defined](https://reader033.fdocuments.net/reader033/viewer/2022050108/5f469681128bc92821574022/html5/thumbnails/2.jpg)
2
Nephrol Dial Transplant 2009; 24:3557-3566
Sopravvivenza per fasce di età, capacità a deambularenumero di comorbidità
![Page 3: LE “EVIDENZE” NEFROLOGICHE · Recommendation No. 5* If appropriate, forgo (withhold initiating or withdraw ongoing) dialysis for patients with AKI CKD or ESRD in certain, well-defined](https://reader033.fdocuments.net/reader033/viewer/2022050108/5f469681128bc92821574022/html5/thumbnails/3.jpg)
3
MORTALITA’ IN PZ. >75 aa
• 40% a 2 mesi (Nordio, SIN 2010)
• 46% a 4 mesi (Robinson, Kidney Int. 2013)
• 58% a 12 mesi (Kurella, NEJM 2009)
Is Maximum Conservative Management an EquivalentTreatment Option to Dialysis for Elderly Patients with
Significant Comorbid Disease?Rachel C. Carson - Clin J Am Soc Nephrol (2009)
Risultati
• Stato funzionale invariato:– al 3° mese: nel 24% dei pazienti
– al 12° mese: nel 13% dei pazienti
• Mortalità: – al 3° mese: 24%
– al 6° mese: 41%
– al 9° mese: 51%
– al 12° mese: 58%
Inizio dialisi caratterizzato da rapido declino dello stato funzionale; la variazione era
indipendente da età, sesso, razza, traiettoria declino pre-dialisi
![Page 4: LE “EVIDENZE” NEFROLOGICHE · Recommendation No. 5* If appropriate, forgo (withhold initiating or withdraw ongoing) dialysis for patients with AKI CKD or ESRD in certain, well-defined](https://reader033.fdocuments.net/reader033/viewer/2022050108/5f469681128bc92821574022/html5/thumbnails/4.jpg)
4
N Engl J Med 2009;361:1539-47.