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Specialist Evaluation in Chronic Kidney Disease: Too Little, Too Late

Norman G. Levinsky, MD
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Current Author Address: Norman G. Levinsky, MD, Boston University Medical Center, 751 Albany Street, L-102, Boston, MA 02118.

Ann Intern Med. 2002;137(6):542-543. doi:10.7326/0003-4819-137-6-200209170-00016
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Maintenance of patients with end-stage renal disease (ESRD) on long-term dialysis is a triumph of modern medicine. In the United States alone, more than 250 000 persons with ESRD, who otherwise would have died, enjoy life—usually of good quality—because of the availability of hemodialysis and peritoneal dialysis. Yet this triumph has a tragic flaw: The lifespan of dialysis patients remains abnormally short. Only about one third survive 5 years. Even patients who start dialysis in their 40s have no more than a 50% chance to live 5 more years (1).

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