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Trends toward earlier initiation of dialysis for patients with chronic renal failure have been noted in Europe and North America. To determine whether early dialysis is associated with prolonged survival, researchers conducted this cohort study of 26,000 Canadians who began dialysis between 2001 and 2007. Early initiation was defined as starting dialysis at an estimated glomerular filtration rate (eGFR) of >10.5 mL/minute/1.73 m2; mean eGFR was 15.5 in early initiators and 7.1 in late initiators.
During average follow-up of 2.3 years, mortality was significantly higher after early initiation than after late initiation (hazard ratio, 1.5). Because early initiators had more comorbidities than late initiators, multivariate adjustment lowered th…