Janmaat CJ, et al. – The effect of glomerular filtration rate (GFR) at dialysis initiation on survival in chronic kidney disease patients was identified, as well as the role of lead–time bias was explored. Results highlighted lead–time bias as a methodological problem, and it also exhibited a clinical impact while assessing the optimal kidney function to start dialysis, thereby lead–time bias was extremely important to correct. No association was observed between early dialysis initiation (eGFR >7.9, mGFR >6.6 mL/min/1.73 m2) and an improvement in survival, with respect to lead–time bias.