The results of a large observational study seem to confirm an association between early initiation of dialysis and increased mortality that is not fully explained by the presence of comorbidities and other confounding variables. However, this paradoxical association may be an artifact resulting from the inaccuracy of using plasma creatinine levels to estimate glomerular filtration rates in patients with severely impaired renal function.
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Krediet, R., Dekker, F. Can plasma creatinine levels guide initiation of dialysis?. Nat Rev Nephrol 6, 563–564 (2010). https://doi.org/10.1038/nrneph.2010.109
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DOI: https://doi.org/10.1038/nrneph.2010.109
