ArticleJournal of the American Society of Nephrology : JASN2015
Trends in the Timing and Clinical Context of Maintenance Dialysis Initiation.
Article in Journal of the American Society of Nephrology : JASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Nondialytic Care vs Dialysis Transition on Hospitalization: Outcomes in Veterans With Advanced Chronic Kidney Disease.Mayo Clinic proceedings · 2026Article
- Association Between Time Spent With Low Posttransplant Glomerular Filtration Rate and Access to Relisting and Retransplantation.Kidney medicine · 2026Article
- Performance of the American Heart Association's PREVENT risk score for cardiovascular risk prediction in a multiethnic population.Nature medicine · 2025Article
- Geographic Dialysis Facility Density and Early Dialysis Initiation.JAMA network open · 2024Article
- Benefits of Incremental Hemodialysis Seen in a Historical Cohort Study.Therapeutics and clinical risk management · 2021Article
- Implication of Trends in Timing of Dialysis Initiation for Incidence of End-stage Kidney Disease.JAMA internal medicine · 2020Article
- Narrative Review of Incremental Hemodialysis.Kidney international reports · 2020Review
- Protocol for a prospective, cluster randomized trial to evaluate routine and deferred dialysis initiation (RADDI) in Chinese population.BMC nephrology · 2019Article
- Time's Up! Start Dialysis Later in Children.Journal of the American Society of Nephrology : JASN · 2019Article
- Higher eGFR at Dialysis Initiation Is Not Associated with a Survival Benefit in Children.Journal of the American Society of Nephrology : JASN · 2019Article
- Starting Renal Replacement Therapy: Is It About Time?American journal of nephrology · 2019Observational
- Dialysis versus Medical Management at Different Ages and Levels of Kidney Function in Veterans with Advanced CKD.Journal of the American Society of Nephrology : JASN · 2018Article
- Incremental dialysis for preserving residual kidney function-Does one size fit all when initiating dialysis?Seminars in dialysis · 2018Review
- Arteriovenous Fistula Maturation in Prevalent Hemodialysis Patients in the United States: A National Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018Observational
- The Relationship of Residual Renal Function with Cardiovascular Morbidity in Hemodialysis Patients and the Potential Role of Monocyte Chemoattractant Protein-1.Kidney diseases (Basel, Switzerland) · 2018Article
- Treatment decisions for older adults with advanced chronic kidney disease.BMC nephrology · 2017Review
- Explaining trends and variation in timing of dialysis initiation in the United States.Medicine · 2017Observational
- Timing of Dialysis Initiation: What Has Changed Since IDEAL?Seminars in nephrology · 2017Review
- Article
- The Transition From the Pre-ESRD to ESRD Phase of CKD: Much Remains to Be Learned.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2017Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Whether secular trends in eGFR at dialysis initiation reflect changes in clinical presentation over time is unknown. We reviewed the medical records of a random sample of patients who initiated maintenance dialysis in the Department of Veterans Affairs (VA) in fiscal years 2000-2009 (n=1691) to characterize trends in clinical presentation in relation to eGFR at initiation. Between fiscal years 2000-2004 and 2005-2009, mean eGFR at initiation increased from 9.8±5.8 to 11.0±5.5 ml/min per 1.73 m(2) (P<0.001), the percentage of patients with an eGFR of 10-15 ml/min per 1.73 m(2) increased from 23.4% to 29.9% (P=0.002), and the percentage of patients with an eGFR>15 ml/min per 1.73 m(2) increased from 12.1% to 16.3% (P=0.01). The proportion of patients who were acutely ill at the time of initiation and the proportion of patients for whom the decision to initiate dialysis was based only on level of kidney function did not change over time. Frequencies of documented clinical signs and/or symptoms were similar during both time periods. The adjusted odds of initiating dialysis at an eGFR of 10-15 or >15 ml/min per 1.73 m(2) (versus <10 ml/min per 1.73 m(2)) during the later versus earlier time period were 1.43 (95% confidence interval [95% CI], 1.13 to 1.81) and 1.46 (95% CI, 1.09 to 1.97), respectively. In conclusion, trends in eGFR at dialysis initiation at VA medical centers do not seem to reflect changes in the clinical context in which dialysis is initiated.
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