Preparing renal replacement therapy in stage 4 CKD patients referred to nephrologists: a difficult balance between futility and insufficiency. A cohort study of 386 patients followed in Brussels

Abstract

The risk of death exceeds that of RRT in stage 4 CKD incident patients aged ≥ 80 years referred to our clinic. Futile preparation for RRT was relatively uncommon (14.9%). We were able to largely avoid futility at the expense of incomplete exposure of patients who eventually started RRT, to the structured PDEP, and of a relatively low (53%) level of AVF created prior to start of HD. Whether and how these figures can be improved will require further investigation.