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Amy N. Ship, MD

JAMA. 2005;294:841.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

At Medical Grand Rounds in January 2003, Glenn Chertow, MD, discussed a 43-year-old woman with end-stage renal disease as she considered renal replacement therapy.¹ Mrs C had had renal insufficiency for 23 years and carried a diagnosis of focal segmental glomerular sclerosis. Her only symptom of renal disease was fatigue, which was improving with erythropoietin therapy. Despite this, her laboratory markers were steadily worsening, and over the months prior to the conference, Mrs C’s nephrologist had begun to discuss her options regarding treatment. She had failed to find a relative who might provide a donor kidney, and at the time of the conference had chosen to prepare for hemodialysis and fistula placement.

Dr Chertow reviewed screening for renal insufficiency and approaches to slow progression of renal disease. He described the clinical and laboratory markers that indicate that a patient requires renal replacement therapy and reviewed the . . . [Full Text of this Article]

MRS C, THE PATIENT



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