Langzeitbetreuung in der Hämodialyse

The outcome of end-stage kidney disease is not influenced by the treatment option of the renal replacement therapy providing an adequate dialysis dose. A number of other factors influence patient outcome. Cardiovascular disease and infections are the major causes of death. Withdrawal from dialysis accounts for 20%. Cardiovascular disease is responsible for 50% of deaths. The reasons underlying such diseases are evoked by reduced kidney function, i.e. hypertension, hyperphosphatemia, anemia, malnutrition, acidosis and lowered residual renal function. The physician plays the central role in long-term treatment, while the patient has to achieve an adequate life style and correct drug intake. He or she is partner in this health care process. The patient’s knowledge and understanding will be provided by physicians (nephrologists) and by training programs. Long-term treatment begins at stage 3–4 of chronic kidney disease, i.e. some years before dialysis treatment begins.