Elección de tratamiento conservador en la enfermedad renal crónica

Abstract Introduction Incidence of use for various renal replacement therapies is well known, but no data are available on the use of conservative treatment. Objective To assess the proportion of patients with chronic kidney failure receiving conservative treatment. Results From July 1, 2013 to June 30, 2014, 232 patients with stage 5 CKD were seen in the Nephrology Department. After having received information on the existing therapeutic options and having known the opinion of their physicians, 81 patients (35%) selected haemodialysis, 56 (24%) preferred peritoneal dialysis, 5 (2%) selected a preemptive transplant from a living donor, and in 90 (39%) a conservative treatment option was selected. In a univariate analysis using logistic regression, variables associated to a preference for conservative treatment were age, Charlson index excluding age, walking difficulties, and the level of functional dependendce, with the first three factors achieving statistical significance in a multivariate analysis. Presence of a severe disease with a poor prognosis was the main reason for selecting a conservative treatment (49%), with the second one being symple, patients refusal to receive a renal replacement therapy (26%). Mortality rate was 8.2/100 patient-months in conservative therapy group versus 0.6/100 patient-months in patients receiving renal replacement therapy ( p Conclusions About 39% of patients with stage 5 CKD seen over a 1-year period in the Nephrology Department received conservative therapy. Age, co-morbidity, and functional disability were the factors associated to selecting a conservative therapy option.