Preparing renal replacement therapy in stage 4 CKD patients referred to nephrologists: a difficult balance between futility and insufficiency. A cohort study of 386 patients followed in Brussels

KDOQI guidelines recommend preparation for renal replacement therapy (RRT) once stage 4 chronic kidney disease (CKD) is reached. Recent studies conducted in the general population and in patients referred to nephrologists have shown that CKD patients, especially the elderly, are much more likely to die than to reach RRT. We investigated whether futile preparation for RRT was performed in CKD patients referred to our nephrology department.