However, primary renal diseases for ESRD are different by race and area and the incidence, prevalence and mortality of CKD vary accordingly.14 Consequently, the CKD screening and prevention programs requires different approaches depending on the patient’s race, habitual and socioeconomic status and be modified in response check details to the situations where they would be conducted. The authors thank Dr Hung-Chun Chen and the organizing committee for providing this opportunity to share experience on prevention and management of CKD. Dr Nan Chen’s work was supported in part by grants from the Leading Academic Discipline Project of Shanghai Health

Bureau (05III001), the Shanghai Leading Academic Discipline Project (T0201) and the Science and Technology Commission of Shanghai Municipality (08dz1900502). The Authors state that there is no conflict of interest regarding the material discussed in the manuscript. “
“Date written: July 2008 Final submission: October 2008 No recommendations possible based on Level I or II evidence (Suggestions

are based on Level III and IV evidence) C646 price As dialysis is an accepted and available mode of treatment for end-stage kidney disease (ESKD) in Australia and New Zealand, the decision concerning acceptance onto a dialysis programme should be made on the basis of the patient’s need. The cardinal factor for acceptance onto dialysis or continuation Methocarbamol of dialysis is whether dialysis is likely to be of benefit to the patient.* *Additional notes: 1 Lack of certainty about whether the treatment will be of benefit to the patient may suggest the use of temporary dialysis or a ‘trial’ so

that dialysis as a treatment option can be evaluated. Survey individual unit documentation of implementation of the above ‘Suggestions for Clinical Care’ and rates of insertion and completion of the checklist titled ‘Approaching ESKD’ (Appendix) in patient notes. These draft guidelines do not refer to temporary dialysis, but expressly consider acceptance onto long-term dialysis, which would be terminated only by the death of the patient, successful renal transplantation, inability to maintain successful dialysis or elective withdrawal of dialysis by the patient. There is broad consensus in Australia and New Zealand that people in our society regardless of age, race, gender, religion and underlying disease have equal rights to access health facilities. Unless the patient has chosen to accept only supportive treatment, individuals and society at large expect that ESKD should not, except in unusual circumstances, be the primary cause of death.