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Health Care Financing Administration, Office of Clinical
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9. Pereira BJG: Optimization of pre-ESRD care: The key
to improved dialysis outcomes. Kidney Int 57:351-365,
2000
10. US Renal Data System: Comorbid conditions and
correlations with mortality risk among 3,399 incident hemo-
dialysis patients. Am J Kidney Dis 20:32-38, 1992
11. Port F: Morbidity and mortality in dialysis patients.
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12. Frankenfield DL, Rocco MV, Frederick PR, Pugh J,
McClellan WM, Owen WF Jr: Racial/ethnic analysis of
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Results from the 1997 ESRD Core Indicators Project. Am J
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design of our study did not allow us to analyze in
a more formal manner these facility or center
effects.
Thus, a number of actionable items can result
in improved intermediate outcomes in patients
during the first 6 months of dialysis therapy.
These items include timely placement of a perma-
nent dialysis access, appropriate initiation of
chronic dialysis therapy, prescribing a dose of
dialysis that meets NKF-DOQI guidelines at the
initiation of dialysis therapy, treatment of anemia
with rHuEPO and intravenous iron, and monitor-
ing and treatment of malnutrition. Guidelines
being developed by both the Renal Physicians
Association and the NKF may improve aware-
ness of these actionable items in the predialysis
population.
13. Dean JA, Burton AH, Coulombier D, Breudel KA,
Smith DC, Burton AH, Dicker RC, Sullivan K, Fagan RF,
Arner TG: Epi Info, Version 6.04a: A Word Processing,
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15. Daugridas JT: Second generation logarithmic esti-
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ACKNOWLEDGMENT
This report is dedicated to the more than 190,000 US
hemodialysis patients who inspire us to improve our under-
standing of dialysis. The authors thank the numerous HCFA
and regional ESRD Network personnel, as well as the
dialysis personnel at more than 2,400 facilities whose dili-
gence and conscientious efforts resulted in the success of
this project, and Laura Furr for excellent secretarial assis-
tance.
16. Norusis MJ: SPSS for Windows Advanced Statistics,
Release 8.0. Chicago, IL, SSPS Inc, 1997
17. National Kidney Foundation: DOQI Clinical Practice
Guidelines for the Treatment of Anemia in Chronic Renal
Failure. Am J Kidney Dis 35:S192-S237, 2000 (suppl 3)
18. National Kidney Foundation: DOQI Clinical Practice
Guidelines for Nutrition in Chronic Renal Failure. Am J
Kidney Dis 35:S17-S104, 2000 (suppl 2)
19. Bonomini V, VangelistaA, Stefoni S: Early dialysis in
renal substitutive programs. Kidney Int 13:S112-S116, 1978
(suppl 8)
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