Abstract
Pre dialysis care in chronic kidney disease patients is well practice in Malaysia. Ideal pre dialysis care requires adequate time for patient education, management of metabolic complications, malnutrition, anaemia, surgical planning and maturation of permanent dialysis vascular access. Many patients with advanced chronic kidney disease (CKD) are now managed in specialised multidisciplinary clinics (MDCs), where the primary goal is to transition patients smoothly onto dialysis. However, despite the many benefits that MDCs offer patients, a significant proportion of patients followed in such clinics still initiate dialysis in an unplanned fashion during a hospital admission, rather than electively as outpatients.
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