Factors associated with suboptimal initiation of dialysis despite early nephrologist referral

摘要: Background. STARRT recently demonstrated that many patients experience suboptimal dialysis starts (defined as initiation an inpatient and/or with a central venous catheter), even when followed by nephrologist for >12 months (NDT 2011). However, did not identify the factors associated of dialysis. The objectives this study were to extend results ascertaining leading in who referred at least 12 prior commencement Methods. At each three Toronto centers, charts consecutive incident RRT identified from 1 January 2009 31 December 2010, predetermined data extracted. Results. A total 436 studied; 52.4% Suboptimal occurred 56.4% these patients. No attempt arteriovenous fistula (AVF) or graft (AVG) was made 65% starts. Factors contributing despite early referral included patient-related delays (31.25%), acuteon-chronic kidney disease surgical (16.41%), late decision-making (8.59%) and others (12.50%). percentage optimal among 14 nephrologists ranged 33 72%. Conclusions. Most started manner, extended period pre-dialysis care. Nephrologists should take responsibility test methods prevent this.