Public Release: 

What factors influence timing of start of dialysis?

The JAMA Network Journals

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.

To read the full article and a related commentary by Peter P. Reese, M.D., M.S.C.E., of the University of Pennsylvania, Philadelphia, and coauthors, please visit the For The Media website.


Related Content: An author audio interview also is available on the For The Media website to preview. The author audio interview will be live when the embargo lifts on the JAMA Internal Medicine website.

(JAMA Intern Med. Published online January 25, 2016. doi:10.1001/jamainternmed.2015.7412. Available pre-embargo to the media at

Editor's Note: The study includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures.

Media Advisory: To contact study corresponding author Susan P.Y. Wong, M.D., email To contact editorial corresponding author Peter P. Reese, M.D., M.S.C.E., email

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