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Letters |

Does Time of Day of Hemodialysis Affect Survival?—Reply

Donald L. Bliwise, PhD; Nancy G. Kutner, PhD
JAMA. 2002;287(10):1262-1264. doi:10.1001/jama.287.10.1261.
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In Reply: Many of these comments focus on other factors that could confound the apparent time-of-day phenomenon that we described. Dr Oserman suggests that patients often are assigned the afternoon slots in maintenance dialysis because the preferred morning slots are filled. In our data, however, there were no differences by patient shift in months on hemodialysis before study entry, nor were there differences in comorbid diseases, such as cardiovascular disease or diabetes, or functional status, as would be expected given the coveted nature of the morning shift for healthier patients, as described by Dr Watnick. Additionally, preference for morning shift because of employment was not an issue for the majority of this population; they were elderly and most were retired.

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