Knowledge Translation Interventions to Improve the Timing of Dialysis Initiation: Protocol for a Cluster Randomized Trial.

3 , 4 Over the past 2 decades, there has been a strong trend toward earlier initiation of dialysis (that is, starting dialysis at a higher level of remaining kidney function) in patients whose kidneys are progressively failing (ie, progressive chronic kidney disease [CKD]). 5 , 6 In a recent Canadian study that examined trends in dialysis initiation, the average estimated glomerular filtration rate (eGFR) at initiation of dialysis increased from 9.3 mL/min/1.73 m 2 in 2001 to 10.2 mL/min/1.73 m 2 in 2007, and the secular increase in the starting eGFR has continued.

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