LONDON, Ontario – Patients who are starting dialysis too early are at an increased risk of death, found an article published today in CMAJ (Canadian Medical Association Journal).
Glomerular filtration rate (eGFR) is a test that describes the flow rate of fluid going through the kidneys and is associated with early dialysis initiation. Current guidelines in the United States place a strong emphasis on eGFR dialysis timing. Analysis of dialysis registries in the United States and Europe indicates that patients are starting dialysis earlier.
This study looked at data on 25,910 adult patients in Canada who started dialysis between 2001 and 2007. The researchers looked at the timing (early vs. late) and the risk of death in these two groups over time.
“We examined a variety of study designs, populations and health care delivery models, all of which support the conclusion that early initiation confers no survival benefit, and argue against preemptive dialysis in asymptomatic patients,” says Dr. William Clark, Nephrologist at London Health Sciences Centre and Scientist at Lawson Health Research Institute, with coauthors. “In contrast to early dialysis initiation, early referral to a nephrologist is consistently associated with better survival.”
The authors conclude that further research into detecting the signs, symptoms and lab tests associated with a higher death rate and worsened quality of life in patients with kidney failure is needed.
About Lawson Health Research Institute
As the research institute of London Health Sciences Centre and St. Joseph's Health Care, London, and working in partnership with The University of Western Ontario, Lawson Health Research Institute is committed to furthering scientific knowledge to advance health care around the world.
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