[When and for whom to start dialytic therapy?].

Patients with increasingly multiple diseases are admitted to dialytic therapies. In acute situations, the indications for dialytic therapy are refractory hyperkalemia, acidosis, fluid load and other symptoms of uremia. In chronic insufficiency the treatment is started when the estimated glomerular filtration rate (eGFR) is 5 to 10 ml/min/1.73m2 and the patient presents with symptoms of renal insufficiency. Dialytic therapy is not the best choice for everybody, because the alleviation of symptoms achieved with the therapy remains minor in comparison with the impairment of the quality of life and the risk of various complications associated with the therapy.