Evidence mapPaperPMID 40630271Full record

ArticleKidney international reports2025

Dialysis Preparedness and Access to the Transplant Waitlist: Evidence From a National United States Cohort Study.

Maxime Raffray, Megan Urbanski, Mohammad Kazem Fallahzadeh, Chengcheng Hu, Sahar Bayat-Makoei, Jessica L Harding

Abstract read
In one paragraph

Article in Kidney international reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Maxime RaffrayDivision of Clinical Epidemiology, Karolinska Institutet, Solna, Sweden.
Megan UrbanskiDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Mohammad Kazem FallahzadehSection of Nephrology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
Chengcheng HuDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Sahar Bayat-MakoeiUniv Rennes, EHESP, CNRS, INSERM, Arènes - UMR 6051, RSMS - U1309, Rennes, France.
Jessica L HardingDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

Funding

Georgia Clinical & Translational Science Alliance (Georgia CTSA)UL1TR002378 · EMORY UNIVERSITY · 2025 to 2025
$9.3M
Institutional Career Development CoreKL2TR002381 · EMORY UNIVERSITY · 2025 to 2025
$1.5M
NCATS NIH HHS KL2 TR002381NCATS NIH HHS UL1 TR002378
6 · The paper itself

Abstract

Introduction: Individuals who initiate dialysis for kidney failure do so with different levels of preparedness. Whether this has downstream effects for access to kidney transplant is unknown. Methods: We identified adults (aged ≥ 18 years) initiating dialysis between 2015 and 2019 from the United States Renal Data System and followed-up with them until waitlisting, death, or end of follow-up (December 31, 2021), whichever occurred first. We grouped dialysis initiation context as follows: group 1 initiated peritoneal dialysis (PD) or hemodialysis (HD) with mature arteriovenous access (AVA), group 2 initiated HD with a catheter and maturing AVA, group 3 initiated HD with a catheter and without a maturing AVA, and group 4 lacked predialysis nephrology care. Fine-Gray subdistribution hazard models were used to assess the association between dialysis initiation context and waitlisting, adjusted for clinical and nonclinical factors, and stratified by age, sex, race, and insurance status. Results: Among 541,861 adults initiating dialysis, 26.9%, 14.9%, 29.8%, and 28.4% were in groups 1, 2, 3, and 4, respectively. Compared with group 1, individuals in groups 2, 3, and 4 were 40% (adjusted hazard ratio [aHR]: 0.60; 95% confidence interval [CI]: 0.59-0.62), 45% (aHR: 0.55 [95% CI: 0.54-0.56]) and 58% (aHR: 0.42 [95% CI: 0.41-0.43]) less likely to be waitlisted. The relative impact of no predialysis nephrology care was most pronounced among older, Black, female, and Medicare insured patients. Conclusion: A large proportion (∼60%) of adults in the US initiate dialysis with no AVA or predialysis nephrology care, with detrimental consequences for downstream transplant access.

Indexed as

epidemiologygender disparitieshealth services researchKidney transplanttrends

Identifiers

PMID40630271
PMCPMC12231010

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.