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October 05, 2009

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Zach

Maybe it's the person's New Year's resolution to quit denying it and get on dialysis.

Bill Peckham

That or EIRI (Eggnog Induced Renal Insufficiency).

It would be interesting to see if there is a seasonal skew in the data one way or another from people who are under a nephrologist's care. Your NYE resolution theory would suggest more people who are under a nephrologist's care transitioning in Q1. The EIRI theory would suggest fewer people who were under a nephrologist's care transitioning - more emergency transitions.

I don't really believe eggnog induces CKD5 but other seasonal factors may - for instance the flu. The flu is seasonal and maybe it is the proverbial back breaking straw. In general if the skew among Q1 patients was towards those who were not under a doc's care then it would suggest some clinical externality makes them vulnerable.

If the skew is towards people under a nephrologist's care then the explanation may well be social/emotional/psychological.

Tpastoe

I would think that, especially if one is under a nephrologist's care, that one would want to put dialysis off over the summer, when family and friends may be more likely free for leisure activities, and the late fall/early winter, when people may say "I'll wait until after the holidays". Personally, I'm glad I've started just at the start of fall when the weather is my favorite, not too warm/not too cool. It's some consolation for the suckiness of dialysis.

Richie Perl

It certainly seems suspicious that there is a seasonal bias.
Perhaps the dummer isn't "convenient" to start dialysis.
For either the patient or the doctor!
(I'm just a cynical New Yorker!)

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