What are the key indications for initiating haemodialysis in patients with chronic kidney disease?

Key indications for initiating haemodialysis in patients with chronic kidney disease (CKD) include:

• Presence of symptoms of uraemia that significantly impact daily living.
• Uncontrollable fluid overload despite medical management.
• Biochemical abnormalities indicative of kidney failure, such as a very low estimated glomerular filtration rate (eGFR) around 5 to 7 ml/min/1.73 m² if there are no symptoms.

The decision to start haemodialysis should be made jointly by the patient (or their family/carers) and the healthcare team, ensuring that symptoms are not caused by non-renal conditions before initiating dialysis.