Abstract: Objective To evaluate the appropriate time for the beginning of dialysis in end stage renal disease (ESRD), we compared the clinical status at the beginning of dialysis in the patients in 2006 with those in 2001. The causes of delayed dialysis and the measures for change of this situation were discussed. Methods Patients of non-diabetic ESRD in this hospital regularly treated with dialysis starting in the periods of Jan. 1 to Dec. 31, 2001 (group A) and Sept. 1, 2005 to Aug. 31, 2006 (group B) were analyzed. Before dialysis treatment their residual renal function presented as estimated glomerular filtration rate (eGFR) from the simplified MDRD equation, uremia complications and the patients treated with emergent dialysis were collected. Results ①eGFR was higher in group B than in group A (5.95mL/min/1.73m2 vs. 5.23mL/min/1.73m2, P<0.05), and the metabolic acidosis was also less severe in group B. Serum albumin, uremia-related cerebro- cardiovascular complications and the number of patients required emergent dialysis were similar between the 2 groups. ② Patients of delayed dialysis usually showed severe anemia, lower serum calcium and higher serum phosphate, and spent more money for the longer hospitalization. More of them required emergent dialysis. ③ The number of delayed dialysis decreased dramatically in group B (P<0.05, as compared with that of group A). On the other hand, the unawareness of having renal diseases and renal failure was the main cause of delayed dialysis (73.92%) in the 2 groups. Conclusions Delayed diagnosis of chronic kidney diseases and chronic renal failure caused the delay of dialysis. Health education, screening of renal diseases in population and re-education for nephrologists are the important measures for the improvement of this situation.

Key words: Time for initiation of dialysis, Glomerular filtration rate, Uremic complications