This is a fellow level lecture. I built it off an old lecture from 2003 or 2004. It is remarkable how much data has emerged since then. Of coarse the IDEAL Trial has put a dagger in the heart of early initiation but the observational data in agreement with abandoning early initiation has also turned.
To fortify this lecture it needs the data on nursing home residents and dialysis outcomes and I’d like to add the recent data on dialysis mortality after the week-end.
All-in-all, its a good foundation.
Joel, that is a great ppt. Thanks for posting it.
I look forward to borrowing from it in future – if you don't mind!
Iain
don't mind at all
Nice looking lecture Joel.
There's a nice paper from Traynor in JASN in 2002 with a good figure highlighting the lead time bias problem with the older retrospective data on early vs late initiation.
Depending on the direction you want to take it you could throw in supporting data from CANUSA and ADEMEX dispelling the myth of dialytic clearance equivalency to native renal clearance.
To add to the Tamura NEJM paper you could also show some of the UK data on conservative care/palliative care and the questionable benefit of initiation in the elderly highly comorbid cohort.
thanks for the comment Hraham, not sure how I missed these
Here to help 🙂