Management of the hemodialysis patient: a European perspective.

This article explores some of the factors which may contribute to the persistence of the differences in outcome between European and US hemodialysis patients. A higher comorbidity of incident and prevalent renal replacement therapy patients, different vascular access policies with less use of arteriovenous fistulas, shorter dialysis times, and higher reutilization of dialysis membranes in the USA may, among other factors, explain the higher mortality compared to Europe and Japan. No major differences in patient referral to the nephrologist, in residual renal function at the start of dialysis, nor in the dialysis dose based on Kt/V urea data were noted.