In multivariable analysis, four factors maintained an independent association with early initiation: heart failure (OR 3.575, 95% CI 1.592–8.025, p = 0.002), serum albumin level <4.0 mg/dL (OR 2.227, 95% CI 1.303-3.773, p = 0.003), BUN/Cr ratio >15 mg/mg (OR 1.918, 95% CI 1.157–3.179, p = 0.012), and hyperuricemia (OR 1.842, 95% CI 1.049–3.234, p = 0.033). This evidence concerns the gene ALB and heart failure.