Seasonal Initiation of Hemodialysis: A Single-Center Experience

Objective

This study aimed to evaluate the seasonal pattern of hemodialysis initiation in a warm/subtropical climate region (Adana) and its association with the mode of initiation, early complications, and mortality. Materials and Methods: A total of 319 patients who started chronic hemodialysis at Adana City Training and Research Hospital, Department of Nephrology, between 2022 and 2025 were retrospectively analyzed. Chi-square/Fisher’s exact and Kruskal–Wallis tests were used for seasonal comparisons. Multivariable logistic regression models adjusted for age, sex, diabetes, hypertension, and cardiovascular disease (coronary artery and/or valvular heart disease) were fitted for emergent initiation and for any early (30-day) complication, with a likelihood-ratio test of season as a whole; 3-month mortality (13 events) was described by season and analyzed with a season-only Firth model. Catheter dysfunction was analyzed among catheter-exposed patients, followed by sensitivity analyses.