UNASSIGNED: Appropriate timing of starting chronic dialysis in @entity1 with @entity740 ( @entity740 ) under nephrology care still is undefined. We systematically reviewed the most recent studies that have compared outcomes of stage 5- @entity740 under conservative versus substitutive treatment. Eleven studies, most in elderly @entity1 , were identified. Results indicate no advantage of dialysis over conservative management in terms of survival, hospitalization or quality of life. This information is integrated with a case report on a middle-aged @entity740 @entity1 followed in our clinic who has remained for 15  years in stage 5 despite severe disease. The @entity1 is a @entity6 @entity1 who underwent right nephrectomy in 1994 because of @entity3299 . In 1999, she commenced regular nephrology care in our clinic and, since 2000, when she was 53  years old, her estimated glomerular filtration rate (eGFR) has been  <=15  ml/ @entity1009 .73  m(2). Over the last decade, despite, several episodes of @entity810 and placement of permanent percutaneous nephrostomy in 2001, renal function has remained remarkably stable, though severely impaired (eGFR 7.7-5.6  ml/ @entity1009 .73  m(2)). Our systematic analysis of the literature and this case report highlight the need for further studies, not limited exclusively to elderly @entity1 , to verify the efficacy of non-dialysis treatment in stage 5- @entity740 @entity1 . Meanwhile, nephrologists may consider that their intervention can safely prolong for several years the dialysis-free condition in @entity454 independently of age.

Stage 5- XXXX under nephrology care: to dialyze or not to dialyze, that is the question.

@entity1 :: ('9606', 'Species') :: ['patients', 'woman', 'patient'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic'] @entity1009 :: ('966', 'Gene') :: ['min/1'] @entity740 :: ('MESH:D051436', 'Disease') :: ['CKD', 'advanced chronic kidney disease'] @entity3299 :: ('MESH:D014398', 'Disease') :: ['renal tuberculosis'] @entity810 :: ('MESH:D058186', 'Disease') :: ['acute kidney injury'] @entity454 :: ('MESH:D007676', 'Disease') :: ['ESRD']
@entity740 :: (MESH:D051436,Disease) :: ['CKD']
