ArticleInternational urology and nephrology2026
Registry of access to chronic dialysis initiation at the Public Health System in Brazil.
Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Recommendations of the Brazilian Society of Nephrology for regulating access to outpatient dialysis in the Brazilian Unified Health System.Jornal brasileiro de nefrologia · 2026Guideline
- Brazilian Dialysis Survey from 1999 to 2024: Trends in Dialysis Modalities and Funding.Kidney360 · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWe aim to analyze the requests for the initiation of kidney replacement therapy (KRT) in the public health system of the state of São Paulo, Brazil.
methodsInitial KRT requests sent to the Regulation Center of the State Department of Health between 01/01/2023 and 12/31/2024 were evaluated. KRT initiation was considered "planned" if it occurred outside the hospital environment or the patient started hemodialysis (HD) with an arteriovenous fistula (AVF).
resultsA total of 8451 individuals from 17 healthcare macroregions were included [median interquartile range (IQR)] age: 62 (51-71) years; male sex: 60%; etiology of CKD: 57% hypertension and 21% diabetes). Conservative predialysis treatment of CKD was implemented for 26% of patients in the state, ranging from 4 to 44% in the macroregions. The percentage of patients initiating HD with AVF was 10% (variation in macroregions: 4-25%), and people who initiated KRT in hospital were 70% (37-94%). The initial modality was HD in 95% of the patients (range: 73-100%) (peritoneal dialysis in 5% [(0-27%)], and the median waiting time for a KRT slot vacancy was 12 (IQR: 6-29) days (1 (1-4) to 31 (14-75) in macroregions). Multiple regression analysis revealed that conservative treatment of CKD was independently associated with planned initiation of KRT (odds ratio [OR] [95% confidence interval (CI) = 4.99 (4.48-5.54); p < 0.001].
conclusionThe results demonstrate the need to adopt actions to implement pre-dialysis care for people with CKD and to mitigate regional inequalities in access to chronic dialysis in this population.
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Registered trials
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.