Counseling patients for renal replacement therapy based on outcomes

Abstract

A 52-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) presents for nephrology follow-up. Her most recent serum creatinine is 2.9 mg/dl and estimated glomerular filtration rate (eGFR) is 28 ml/min/1.73m 2. She is married, has no children, and works full-time as a health care administrator. She feels well except that she finds herself more fatigued at the end of each workday than at previous visits. She denies nausea, anorexia, edema, or pruritis. She has not required erythropoietic stimulating agents to date. One sister with ADPKD has received a transplant from a brother. One other sister, age 54, has had a normal renal ultrasound and is interested in donating a kidney to the patient. The patient wishes to discuss her future renal replacement therapy (RRT) options.