What factors influence timing of start of dialysis?

A new study used electronic medical records from the Department of Veterans Affairs to examine factors that influence the timing of the initiation of dialysis, according to an article published online by JAMA Internal Medicine.

The article by Susan P.Y. Wong, M.D., of the University of Washington, Seattle, and coauthors suggests interrelated processes were at play, including physician practices, the momentum for the initiation of dialysis including precipitating clinical events, and patient-physician dynamics, which were sometimes adversarial.

"Our findings offer insight into the complex processes that shape the timing of maintenance dialysis in real-world clinical settings and suggest that there may be opportunities to make these processes more patient centered" the article concludes.