6/28/23, 11:32 PM IDEAL Pathway Feedback Search Clinical Topics Home Studies IDEAL IDEAL Disease Chronic kidney disease Trial question What is the role of early initiation of dialysis in patients with stage V CKD? Study design Multi-center Open label RCT Population Characteristics of study participants 35.0% female N = 828 65.0% male 828 patients (286 female, 542 male) Inclusion criteria: patients 18 years of age with progressive CKD and an eGFR between 10.0 and 15.0 mL/min/1.73 m of body-surface area Key exclusion criteria: younger than 18 years of age, estimated GFR < 10.0 mL/min, plans to receive a kidney transplant from a live donor within the next 12 months, recently diagnosed cancer that was likely to affect survival, or unable to provide written informed consent Interventions N=404 early dialysis initiation (initiation of dialysis when the estimated GFR was 10.0-14.0 mL/min) N=424 late dialysis initiation (initiation of dialysis when the estimated GFR was 5.0-7.0 mL/min) Primary outcome All-cause death 37.6 37.6 % 36.6 https://web.pathway.md/studies/rec5DwB34goo84j81 1/2 6/28/23, 11:32 PM IDEAL Pathway 36 6 28.2 % 18.8 % 9.4 % No significant difference 0.0 % Early dialysis initiation Late dialysis initiation No significant difference in all-cause death (37.6% vs. 36.6%; HR 1.04, 95% CI 0.83 to 1.3) Secondary outcomes No significant difference in the incidence of cardiovascular events (10.9 /100 py vs. 8.8 /100 py; HR 1.23, 95% CI 0.97 to 1.56) Safety outcomes No significant difference in frequency of adverse events. Conclusion In patients 18 years of age with progressive CKD and an eGFR between 10.0 and 15.0 mL/min/1.73 m of body-surface area, early dialysis initiation was not superior to late dialysis initiation with respect to a all-cause death. Reference Cooper BA, Branley P, Bulfone L et al. A randomized, controlled trial of early versus late initiation of dialysis. N Engl J Med. 2010 Aug 12;363(7):609-19. Open reference URL https://web.pathway.md/studies/rec5DwB34goo84j81 2/2