Abstract: 【Abstract】Chronic kidney disease is an important illness that endangers human health. With the increase of patients with end-stage renal disease (ESRD), more patients have to use renal replacement therapy. This article reviews the characteristics of the dialysis patients at the initial stage combined with the previous research about this issue. At present, controversy still exists among experts on the appropriate stage to start dialysis. The disease stage that dialysis begins is relatively late in ESRD patients in China. Hemodialysis is the renal replacement therapy most widely used in the world. Most patients use central venous catheterization as the first vascular access to start hemodialysis. The mortality rate of dialysis patients at the initial stage differs among different countries and different races. The most common cause of death is cardiovascular disease. The major risk factors that affect the mortality of dialysis patients at the initial stage include old age, short time of kidney care before dialysis, diabetic patients, complications, central venous catheterization as the first vascular access, and hypoproteinemia.

Key words: End-stage renal disease, Initial dialysis, Mortality, Vascular access, Cardiovascular events