Early initiation of dialysis fails to prolong survival in patients with end-stage renal failure

Traynor, Jamie P.; Simpson, Keith; Geddes, Colin C.; Deighan, Christopher J.; Fox, Jonathan G.

doi:10.1093/ndt/gfh009

Cited by 49 publications

(55 citation statements)

References 5 publications

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“…In recent years, there has been a shift towards an earlier start in both Europe and the USA [5, 6]. However, recent observational studies have been unable to confirm any benefit of early dialysis initiation [7–12]. On the contrary, these studies showed that patients starting the dialysis at a lower eGFR level survived significantly longer.…”

Section: Introductionmentioning

confidence: 99%

No survival benefit from early-start dialysis in a population-based, inception cohort study of Swedish patients with chronic kidney disease

Evans

Tettamanti

Nyrén

et al. 2010

Journal of Internal Medicine

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Abstract. Evans M., Tettamanti G., Nyrén O., Bellocco R., Fored C.M., Elinder C.-G. (Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden; University of Milano-Bicocca, Milan, Italy; Karolinska Institutet, Stockholm, Sweden) No survival benefit from early-start dialysis in a population-based, inception cohort study of Swedish patients with chronic kidney disease. J Intern Med 2011; 269: 289-298.Objective. To investigate how the timing of dialysis initiation is associated with mortality.Design. Population-based, prospective, observational cohort study.Setting. Clinical laboratories (n = 69) provided information on all patients in Sweden whose serum creatinine level for the first time and exceeded 3.4 mg dL )1 (men) or 2.8 mg dL )1 (women) between 20 May 1996 and 31 May 1998.Subjects. All patients (n = 901), aged 18-74 years, in whom the cause of serum creatinine elevation was chronic kidney disease, were included in the study; participants were interviewed and followed for 5-7 years. Conclusion. We found no survival benefit from early initiation of dialysis.

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Section: Introductionmentioning

confidence: 99%

No survival benefit from early-start dialysis in a population-based, inception cohort study of Swedish patients with chronic kidney disease

Evans

Tettamanti

Nyrén

et al. 2010

Journal of Internal Medicine

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“…To what extend the timing of dialysis initiation influences survival remains as yet questionable. By contrast, Traynor[17] recently demonstrated that early initiation of dialysis may even be detrimental. There is currently one controlled, randomized study addressing this question[18], and the perspective may change once high level evidence is obtained.…”

Section: Discussionmentioning

confidence: 99%

Active collaboration with primary care providers increases specialist referral in chronic renal disease

et al. 2004

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Background: Late referral to specialist nephrological care is associated with increased morbidity, mortality, and cost. Consequently, nephrologists' associations recommend early referral. The recommendations' effectiveness remains questionable: 22-51% of referrals need renal replacement therapy (RRT) within 3-4 months. This may be due to these recommendations addressing the specialist, rather than the primary care providers (PCP).

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“…Uraemic symptoms often but not invariably occur in the eGFR range between 5 and 10 mL/min per 1.73 m 2. Survival advantage of early start of dialysis was not confirmed by published trials . For example, in the Initiating Dialysis Early and Late Study (IDEAL) study, asymptomatic patients started on dialysis at eGFR 5–7 mL/min per 1.73 m 2 had similar survival with those dialyzed at eGFR 10–14 mL/min per 1.73 m 2.…”

Section: Initiation Of Dialysismentioning

confidence: 99%

Clinical practice guidelines for the provision of renal service in Hong Kong: Peritoneal Dialysis

Szeto

2019

Nephrology

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Early initiation of dialysis fails to prolong survival in patients with end-stage renal failure

Cited by 49 publications

References 5 publications

No survival benefit from early-start dialysis in a population-based, inception cohort study of Swedish patients with chronic kidney disease

No survival benefit from early-start dialysis in a population-based, inception cohort study of Swedish patients with chronic kidney disease

Active collaboration with primary care providers increases specialist referral in chronic renal disease

Clinical practice guidelines for the provision of renal service in Hong Kong: Peritoneal Dialysis

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