For example, although we adjusted for sex, age, diabetes mellitus, cardiovascular disease, cancer, late referral dialysis modality, serum bicarbonate, and serum albumin at dialysis initiation between the SDM program and usual care groups, we could not account for other factors, such as family or social support, health literacy, acute kidney injury, and medication use, which may have contributed to the differences in unplanned dialysis incidence. This evidence concerns the gene ALB and acute kidney injury.