{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:11Z","timestamp":1792785851363,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Council UK Career Development Award","award":["MR\/Y011139\/1"],"award-info":[{"award-number":["MR\/Y011139\/1"]}],"id":[{"id":"https:\/\/ror.org\/03x94j517","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the UK, nearly half of patients with end stage kidney disease (ESKD) who initiate dialysis do so in an unplanned manner. A reduced quality of life, increased number of hospitalisations, and higher rates of mortality are just a few of the consequences of unplanned dialysis initiation (UDI). Our study examined factors associated with UDI in patients with ESKD in England, focusing on the effects of ethnicity and late presentation (LP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using data from the UK Renal Registry on 26\u2009512 adult patients initiating dialysis between 2019 and 2023. UDI was defined as starting dialysis via a tunnelled or non-tunnelled line. We ran univariable and multivariable (multilevel) logistic regression analyses to examine risk factors of UDI, then tested for interactions between ethnicity and other key risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Just under half of the population had a UDI (49%), with Black and \u2018Other\u2019 patients having increased odds (1.36 and 1.29, respectively) of having a UDI than White patients, after adjusting for age. Unsurprisingly, the age-adjusted analyses also showed that LP and UDI were strongly associated (odds ratio (OR) 8.03, 95% confidence interval (CI) 7.38\u20138.74). Among late presenters, Asians had lower odds of UDI (OR 0.77, 95% CI 0.61\u20130.99) than Whites. For non-late presenters, the odds of UDI were higher in Asians (OR 1.18, 95% CI 1.09\u20131.28), Blacks (OR 1.47, 95% CI 1.32\u20131.64), and \u2018Other\u2019 (OR 1.30, 95% CI 1.08\u20131.57) compared to Whites (ethnicity and LP interaction P &amp;lt; 0.001). UDI was also associated with being more deprived, having an acute kidney injury, diabetes, higher comorbidity burden and history of cancer, heart failure, myocardial infarction, and minimal engagement with outpatient services before starting dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study highlighted ethnicity as an important risk factor for UDI. Further, timing of presentation appears to alter ethnic differences in UDI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag287","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:11:42Z","timestamp":1788181902000},"source":"Crossref","is-referenced-by-count":0,"title":["Examining factors associated with catheter-defined unplanned dialysis initiation: a UK Renal Registry analysis"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2958-8894","authenticated-orcid":false,"given":"Winnie","family":"Magadi","sequence":"first","affiliation":[{"name":"UK Renal Registry, UK Kidney Association , Bristol ,","place":["UK"]},{"name":"Population Health Sciences, Bristol Medical School , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Birnie","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6648-3007","authenticated-orcid":false,"given":"Yoav","family":"Ben-Shlomo","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergus","family":"Caskey","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0988-9339","authenticated-orcid":false,"given":"Shalini","family":"Santhakumaran","sequence":"additional","affiliation":[{"name":"UK Renal Registry, UK Kidney Association , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026100800165879000_bib1","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1093\/ckj\/sfy118","article-title":"Causes and risk factors for acute dialysis initiation among patients with end-stage kidney disease-a large retrospective observational cohort study","volume":"12","author":"Arulkumaran","year":"2019","journal-title":"Clin Kidney J"},{"key":"2026100800165879000_bib2","doi-asserted-by":"publisher","first-page":"sfae333","DOI":"10.1093\/ckj\/sfae333","article-title":"An updated systematic review of the risk factors for unplanned dialysis initiation","volume":"17","author":"Magadi","year":"2024","journal-title":"Clin Kidney J"},{"key":"2026100800165879000_bib3","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1471-2369-10-22","article-title":"An integrated review of \u201cunplanned\u201d dialysis initiation: reframing the terminology to \u201csuboptimal\u201d initiation","volume":"10","author":"Mendelssohn","year":"2009","journal-title":"BMC Nephrol"},{"key":"2026100800165879000_bib4","doi-asserted-by":"publisher","first-page":"e0155987","DOI":"10.1371\/journal.pone.0155987","article-title":"Type of referral, dialysis start and choice of renal replacement therapy modality in an international integrated care setting","volume":"11","author":"Marr\u00f3n","year":"2016","journal-title":"PLoS ONE"},{"key":"2026100800165879000_bib5","doi-asserted-by":"publisher","first-page":"3240","DOI":"10.1093\/ndt\/gfm387","article-title":"Why do patients known to renal services still undergo urgent dialysis initiation? 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