Evidence map›Paper›PMID 40510616›Full record

ArticleKidney medicine2025

Association of Primary Care Continuity With Home Dialysis, Transplantation, and Utilization of Medical Services for Patients Starting Hemodialysis.

Cole S Wyman, Maya Djerboua, Kristin K Clemens, Ziv Harel, Manish M Sood, Samuel A Silver

Abstract read
In one paragraph

Article in Kidney medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Continuity of care in primary care: is it time to demand it?The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Cole S WymanQueen's University, Kingston, Ontario, Canada.
Maya DjerbouaICES, Ontario, Canada.
Kristin K ClemensICES, Ontario, Canada.
Ziv HarelICES, Ontario, Canada.
Manish M SoodICES, Ontario, Canada.
Samuel A SilverICES, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rationale & Objective: Primary care may help patients starting dialysis with emotional support and access to health care services. It is unknown whether consistently visiting the same primary care physician (PCP) can strengthen patient confidence to select home dialysis, help facilitate medical appointments for transplantation, or increase care access. Study Design: A population-based retrospective cohort study. Setting & Participants: Patients initiating maintenance hemodialysis from 2007 to 2017 in Ontario, Canada. Exposure: High PCP continuity using the usual provider of care index (an established measure of PCP continuity), defined as >75% of PCP visits with the same PCP in the 2 years before dialysis initiation. Outcomes: Primary outcomes were time to home dialysis (peritoneal or hemodialysis) and transplantation. Secondary outcomes included specialist visits, cancer screening, influenza vaccination, and measures of diabetes care. Analytical Approach: Propensity scores to match patients with high and low PCP continuity. Results: We identified 9,530 matched pairs. High PCP continuity was not associated with increased home dialysis (14.0 events per 100 person-years vs 14.0 events per 100 person-years; subdistribution hazard ratio 1.00; 95% CI, 0.97-1.04) or transplantation (4.3 events per 100 person-years vs 4.5 events per 100 person-years; subdistribution hazard ratio 0.97; 95% CI, 0.90-1.04). High PCP continuity was associated with greater colon cancer screening (hazard ratio 1.07; 95% CI, 1.01-1.14), influenza vaccination (hazard ratio 1.33; 95% CI, 1.27-1.39), and comprehensive diabetes care (hazard ratio 1.23; 95% CI, 1.14-1.33). Limitations: Residual confounding is possible. Conclusions: High PCP continuity before dialysis initiation was not associated with increased utilization of home dialysis or transplantation but was associated with greater colon cancer screening, influenza vaccination, and comprehensive diabetes care. Additional work is needed to clarify how primary care may best benefit this patient population.

Indexed as

end-stage kidney diseaseHemodialysisprimary care

Identifiers

PMID40510616
PMCPMC12152618

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.