Wearable Artificial Kidney Status — ESENeph MCQ

Correct answer: D — Symptom- and complication-based shared dialysis timing

The best answer is “Symptom- and complication-based shared dialysis timing”. KDIGO bases initiation on the whole clinical picture, including uraemic symptoms, refractory volume or metabolic problems, nutrition, cognition, quality of life and informed preference. Close monitoring and preparation continue while dialysis is deferred. “The eGFR value alone, requiring dialysis today” is less appropriate because there is no universal eGFR threshold in an otherwise stable asymptomatic person “Chronological age as the sole criterion” is less appropriate because age informs shared decision-making but does not determine need for kidney replacement therapy “Serum creatinine concentration without clinical context” is less appropriate because creatinine is influenced by muscle mass and cannot independently define treatment need “Dialysis access availability rather than clinical need” is less appropriate because prepared access supports safe initiation but is not itself an indication to start

Reference: KDIGO dialysis initiation conference report: https://kdigo.org/wp-content/uploads/2017/02/KDIGO-Dialysis-Initiation-conf-report-FINAL.pdf