INTRODUCTION
DR SHIP: Mrs C is a 43-year-old woman who has had renal insufficiency for 23 years. She works as a nurse assistant part time and lives with her husband and son outside Boston. She has indemnity insurance.
Mrs C was first found to have protein in her urine when she was 20 years of age. No intervention was made at that time. She was followed up clinically until her 30s, when a new internist referred her to a kidney specialist. In 1995, she underwent a kidney biopsy and was diagnosed as having focal segmental glomerular sclerosis. Soon after, she became pregnant and was told that her pregnancy might speed the progression of her kidney disease. She chose to proceed and had a healthy pregnancy and delivery without any symptoms or complications.
During the past few years, Mrs C's nephrologist has told her . . . [Full Text of this Article]
MRS C: HER VIEW
AT THE CROSSROADS: QUESTIONS FOR DR CHERTOW
Epidemiology of ESRD in the United States
Screening for and Slowing Progression of Chronic Kidney Disease
Clinical and Laboratory Indicators of Uremia
Criteria for Selecting Treatment Options in ESRD
Geographic and Other Sources of Variation in Modality Selection
Contraindications to Specific ESRD Treatment Options
To Fear or to Embrace Dialysis?
Specific Risks and Benefits
Costs of Dialysis
Recommendations for Mrs C
The Future
QUESTIONS AND DISCUSSION
