End stage renal failure: Discrepancy between theoretical practice and reality
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:133A 1997
Late referral to nephrologists of pts with ESRF may be detrimental and associated with risks for complications and early mortality in the period after commencing dialysis treatment.
The authors reviewed all pts who started regular dialysis treatment (RDT) in their county during 1995 (n=179, incidence 87.7/106 inhabitants). Median creatinine at the first nephrology consultation was 260 µmol/l, 25% of the pts had a creatinine clearance <10 ml/min and 30% started RDT within 6 months. The consequences of late referral (>6 months before start of RDT) were longer hospitalization (2413 vs. 1111 days in pts referred >6 months before commencing RDT, p<0.001), absence of vascular access when starting RDT (50% vs. 19 %), and less frequent use of autonomous dialysis techniques 8 % vs. 32 %).
Comment: The benefit of early referral to the nephrology team is not restricted to the above-mentioned issues and other direct medical measures. It also includes several important interventions by members of the team, such as counseling by dieticians, nurses and social workers. (Peter F. Barany, M.D., Stockholm, Sweden)
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ASN 30th Annual Meeting, San Antonio
CRF by problem area : Progression
CRF: Problem Areas : Outcomes (Morbidity, Mortality)