No Higher Death Risk with a Later Dialysis Start

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PRAGUE—Early referral patients who start dialysis with an estimated glomerular filtration rate (eGFR) below 6 mL/min/1.73 m2 are not at increased risk of death compared with those who start dialysis at an eGFR above 6, a study showed.

The study included 205 subjects who started dialysis after an average 13-month follow-up. After an average three years, 45% of patients died: 40% and 54% of those who started dialysis with an eGFR below and above 6, respectively, Pietro Dattolo, MD, and collaborators at SM Annunziata Hospital in Florence, Italy, reported at the European Renal Association-European Dialysis and Transplant Association 48th congress.

The study showed that age was the main determinant of death. Each one-year increment in age was associated with a 6% increased risk of death.

Over the past decade in developed countries, Dr. Dattolo's group observed, there has been a trend of increasing eGFR at the start of dialysis. According to European guidelines, they noted, dialysis should start at an eGFR of 8-10, provided there is no evidence of uremia or malnutrition.

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