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A significant proportion of early dialysis mortality occurs after an acute start.
We hypothesize that CVC mortality may be overestimated without considering the influence of an acute start.
After excluding acute start patients, the adjusted HR fell to 1.03 (95 % CI [0.67-1.57]).
In addition, the definition of an acute start differs from the unplanned definition used in REIN cohort studies [ 42, 43].
Finally, the acute event prompting dialysis initiation in acute start patients was determined using electronic patient records.
Additional studies should be conducted to further establish the potential modifying effect of an acute start on CVC associated mortality.
Similar(41)
Cells were treated with IL-13 for 14 days (chronic) starting on the first day of ALI, or for 3 days (acute) starting on day 11 of ALI (Fig. 1 a, b).
After excluding all acute starts, 349 chronic start patients remained for further analysis.
Prior registry reports may have overestimated CVC mortality, as acute starts were not considered.
We only classified AKI/ACKD patients who started dialysis as "acute starts", but not those with previously undiagnosed or uninvestigated late stage CKD who presented late.
Another consideration is that the comparable survival for CVC vs. AVF/PD catheter access after exclusion of acute starts may be related to access conversion.
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