Ferguson TW, et al. - Researchers examined the correlation of the dissemination of the Initiating Dialysis Early and Late (IDEAL) randomized clinical trial with changes in the proportion of patients who initiate dialysis early in Canada. As per IDEAL trial, no improved survival or clinical outcomes were evident in correlation with early initiation of dialysis. They conducted this interrupted time series analysis involving 28,468 patients with incident dialysis. Following trial publication, there appeared a statistically significant immediate decrease in the proportion of early dialysis initiations and also there was a change in the initiation trend between the pretrial and posttrial periods. Acute inpatient dialysis initiations, the proportion of patients receiving home dialysis as the initial modality, or the proportion of arteriovenous access creation at hemodialysis initiation did not show statistically significant differences. These findings indicated an immediate and sustained change in the timing of dialysis initiation in Canada in correlation to the IDEAL trial.