Observational studyBMC nephrology2017
Timing of commencement of maintenance dialysis and mortality in young and older adults in Singapore.
Observational study in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Update of dialysis initiation timing in end stage kidney disease patients: is it a resolved question? A systematic literature review.BMC nephrology · 2023Pooled it
- Risk factors for mortality in elderly haemodialysis patients: a systematic review and meta-analysis.BMC nephrology · 2020Pooled it
- Early Versus Late Initiation of Dialysis in CKD Stage 5: Time for a Consensus.Kidney international reports · 2025Review
- Article
- Early initiation of PD therapy in elderly patients is associated with increased risk of death.Clinical kidney journal · 2021Article
- Serum albumin changes and mortality risk of peritoneal dialysis patients.International urology and nephrology · 2020Article
- In-hospital mortality among incident hemodialysis older patients in Peru.International health · 2020Article
- Assessment of dialysis initiation by a fuzzy mathematics equation (ADIFE): a study protocol for a randomised controlled trial.BMJ open · 2019Article
- Cardiorenal syndrome in incident peritoneal dialysis patients: What is its effect on patients' outcomes?PloS one · 2019Article
- Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe benefit of early dialysis initiation remains controversial with a paucity of data in Asians. Therefore, we undertook this study to investigate the association between timing of initiation of dialysis and mortality in Singapore.
methodsThe study used data from the Singapore Renal Registry database on 3286 patients with incident end-stage renal disease (ESRD) who commenced maintenance dialysis between January 2008 and December 2011. The data was further linked with the National Death Registry to acquire survival information until December 2013. We classified serum creatinine-based, estimated glomerular filtration rate (eGFR) by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation at the start of dialysis into 3 categories: Early (≥10 ml/min/1.73m
resultsIn the unadjusted analysis, both early and intermediate dialysis initiation groups were at greater risk of death relative to late dialysis (Early: HR = 2.47; Intermediate: HR = 1.54). In the multivariate model, a significant interaction was detected between age and eGFR at dialysis initiation (p = 0.04). Adjusted mortality risk progressively increased with earlier initiation of dialysis for patients aged 18-54 years (p = 0.006) and aged 55 to 64 years (p < 0.001), and no statistically significant difference was observed for patients aged 65 years or older (p = 0.12).
conclusionsEarly versus later initiation of dialysis was associated with significantly higher risk of mortality in Singapore's non-elderly population, and appeared to offer no survival advantage among the elderly.
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