Outcome comparisons by prescribable treatment options

Abstract

Mortality and morbidity of hemodialysis patients results from a number of factors, some of which are potentially under the control of the nephrologist. Dialysis dose is the most important of these factors, but other comorbid factors have been identified. These include attainment of appropriate hemoglobin concentrations, good nutrition, control of calcium and phosphorus metabolism, lipids, and blood pressure, as well as less quantitative factors such as psychological well-being and patient-physician contact. However, other factors outside the nephrologist's control also affect morbidity and mortality, particularly with respect to multi-organ damage that can occur if renal replacement therapy is not started early in the course of renal disease. This paper seeks to outline many of the factors that affect morbidity and mortality. © 2000 by the International Society of Nephrology.