{
  "abstract": "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. Results: A total of 58.3% of patients started dialysis emergently and 41.7% in a planned manner; only 11.3% had an arteriovenous fistula as initial vascular access. No significant seasonal differences were found in initiation type, indications, or the frequency of any early complication (161/314, 51.3%; p = 0.090). In the adjusted complication model, spring versus summer gave OR = 2.33 (95% CI: 1.23–4.41, p = 0.009; Holm-adjusted p = 0.028 across the three season contrasts), but the omnibus test of seasons was not significant (p = 0.069), and spring did not differ significantly from autumn or winter. Among catheter-exposed patients, catheter dysfunction occurred in 31.4% (22/70) in the spring and 16.5% (13/79) in the summer (p = 0.035; four-season omnibus p = 0.191); this contrast was not significant after excluding initiations from February to December 2023 (p = 0.111) or when the season was assigned at the midpoint of the risk window (p = 0.114). Season was not associated with emergent initiation (omnibus p = 0.230) or with 3-month mortality (Firth OR for spring versus summer 1.12, 95% CI: 0.28–4.48). Conclusions: Hemodialysis initiation in Adana was not associated with a winter-peak pattern in initiation counts or blood pressure. Spring initiation was associated with a higher frequency of early complications, mainly catheter dysfunction, but this exploratory single-center finding was not supported by the four-season omnibus tests and was sensitive to analytic choices, and none of the 33 seasonal omnibus tests remained significant after Holm correction. It is hypothesis-generating only and does not support a seasonal practice recommendation; confirmation in larger, multicenter, prospective studies is needed.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Adana City Training and Research Hospital, 01230 Adana, Türkiye",
    "Department of Internal Medicine, Adana City Training and Research Hospital, 01230 Adana, Türkiye",
    "Department of Internal Medicine, Erzin State Hospital, 31960 Hatay, Türkiye"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Derya Başak Tanburoğlu",
      "orcid": "0000-0001-5600-0702"
    },
    {
      "affs": [
        0
      ],
      "name": "Emrah Günay"
    },
    {
      "affs": [
        1
      ],
      "name": "Hatice Geçol"
    },
    {
      "affs": [
        1
      ],
      "name": "İbrahim Dayanan"
    },
    {
      "affs": [
        1
      ],
      "name": "Muhammed Emin Arslan"
    },
    {
      "affs": [
        2
      ],
      "name": "Gökçe Paşa"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2yvca02pyzatt.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208139",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705731/?tool=EBI",
  "id": "2yvca02pyzatt",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8139",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2727|Dialysis and Renal Disease Management"
    ]
  ],
  "openalex": "W7223066262",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705731/pdf/?tool=EBI",
  "pmcid": "PMC13705731",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/2yvca02pyzatt.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208139",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8139"
    },
    {
      "first_seen": "2026-10-30T12:21:44Z",
      "native_id": "PMC:PMC13705731",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705731"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Dialysis and Renal Disease Management",
      "subfield": "general"
    }
  ],
  "title": "Seasonal Initiation of Hemodialysis: A Single-Center Experience",
  "title_text": "Seasonal Initiation of Hemodialysis: A Single-Center Experience",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:44Z",
  "url": "https://research.draconitic.com/paper/2yvca02pyzatt",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}