Caro Martinez, AraceliOlry-de-Labry-Lima, AntonioMuñoz Terol, Jose ManuelMendoza Garcia, Oscar JavierRemon Rodriguez, CesarGarcia Mochon, LeticiaCastro de la Nuez, PabloAreste Fosalba, Nuria2023-01-252023-01-252019-06-16Caro Martínez A, Olry de Labry Lima A, Muñoz Terol JM, Mendoza García ÓJ, Remón Rodríguez C, García Mochón L, et al. Optimal start in dialysis shows increased survival in patients with chronic kidney disease. PLoS One. 2019 Jul 30;14(7):e0219037.http://hdl.handle.net/10668/14339To compare the survival among patients with chronic kidney disease who had optimal starts of renal replacement therapy, dialysis or hemodialysis, with patients who had suboptimal starts. A retrospective cohort consisting of >18 year-old patients who started renal replacement therapy, using peritoneal dialysis or hemodialysis, in any public hospital or associated center of the Andalusian Public Health System, between the 1st of January of 2006 and the 15th of March of 2017. The optimal start was defined when all the following criteria were met: a planned dialysis start, a minimum of six-month follow-up by a nephrologist, and a first dialysis method coinciding with the one registered at 90 days. The information was obtained from the registry of the Information System of the Transplant Autonomic Coordination of Andalusia. A total of 10,692 patients were studied. 4,377 (40.9%) of these patients died. A total of 4,937 patients (46.17%) achieved optimal starts of renal replacement therapy and showed higher survival rates (HR 0.669; 95% CI 0.628-0.712) in the multivariate analysis of Cox regression model. Patients with an optimal start of renal replacement therapy have a greater survival than those who had a non-optimal start. Therefore, the necessary measures should be encouraged to increase the optimal start of the patient in dialysis.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/HumansAdolescentNephrologistsSurvival RatePublic HealthRenal Replacement TherapyPeritoneal DialysisRenal Insufficiency, ChronicHospitals, PublicAdultAgedCohort StudiesFemaleHumansKaplan-Meier EstimateMaleMiddle AgedProportional Hazards ModelsRegistriesRenal DialysisRenal Insufficiency, ChronicRetrospective StudiesSpainTime Factorsresearch article31361758open accessDiálisis renalEstimación de Kaplan-MeierEstudios retrospectivosEstudios de cohortesFactores de tiempoInsuficiencia renal crónicaModelos de riesgos proporcionalesPersona de mediana edadSistema de registros10.1371/journal.pone.02190371932-6203PMC6667140https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0219037&type=printablehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667140/pdf