The document compares late referral versus early referral for patients needing dialysis, showing that early referral results in longer survival on dialysis. It initially concludes that early referral has a large effect on survival on dialysis. However, it then presents additional information showing that while early referral leads to earlier initiation of dialysis and prolonged survival on dialysis, it does not ultimately change overall patient survival.

1. Late referral
Early referral
Survival (months)
Initiation of dialysis
Conclusion: early referral has a large effect
on the survival on dialysis
Wednesday, March 11, 2009

2. Late referral
Early referral
Survival (months)
GFR of 10 mL/min
Wednesday, March 11, 2009

3. Initiation of dialysis for late referrals
Late referral
Early referral
Survival (months)
Initiation of dialysis for early referrals
GFR of 10 mL/min
Wednesday, March 11, 2009

4. Survival time off
dialysis gained by Initiation of dialysis for late referrals
the late initiation
of dialysis
Late referral
Early referral
Survival (months)
Initiation of dialysis for early referrals
GFR of 10 mL/min
New conclusion: early referral results in
earlier initiation of dialysis and prolonged
survival on dialysis but does not change
patient survival.
Wednesday, March 11, 2009