Trends in Timing of Long-Term Dialysis Initiation

Dialysis is being initiated at higher glomerular filtration rates, despite lack of proven benefit.

Research has shown that long-term dialysis for most patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR], <15 mL/minute/1.73 m²) should be initiated based on development of symptoms rather than at a specific eGFR cutoff, because early initiation does not improve outcomes compared with delayed initiation (NEJM JW Gen Med Aug 15 2010 and N Engl J Med 2010; 363:609). Yet, evidence suggests that the percentage of patients in whom early dialysis is initiated is increasing. In this study, researchers analyzed data from a large California health system and determined trends in long-term dialysis initiation by eGFR level.

Data were obtained in successive 3-year intervals during 2001 to 2018. Patients' mean age wa…

Reviewing Author

Paul S. Mueller, MD, MPH, FACP

Disclosures

Nothing to disclose

Paul S. Mueller, MD, MPH, FACP

Disclosures

Nothing to disclose

Trends in Timing of Long-Term Dialysis Initiation

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Reviewing Author