Highlights
- •In our centre, only a minority of CKD patients were referred to nephrology.
- •Younger male patients with CKD4 were more likely to be referred.
- •Urine investigations remain largely underutilised.
- •Urine tests were more likely to occur in diabetes, CKD3B or worse and if referred.
Abstract
Background
Early referral of CKD patients to nephrology teams (NT) is vital to identify patients
most likely to progress, delay decline of excretory function, and provide planned
RRT. Unfortunately, many are still being referred late.
Methods
We conducted a retrospective analysis to investigate referral rates, predictors of
non-referral, and performed urine investigations in hospitalised CKD patients.
Results
Out of 388 patients studied, 5.6%, 11.4%, and 16.4% in CKD3A, 3B, and 4 + 5, respectively, were referred to an NT upon discharge (CKD3A vs. CKD4 + 5, p = 0.016). For every additional year of age, the odds of being referred decreased by
5% (OR: 0.95, CI: 0.92–0.98, p = 0.003). Patients were more likely to be referred to an NT if they were males (OR:
2.31, CI: 1.09–4.90, p = 0.029) and having reached CKD 4 + 5 (OR: 3.99, CI: 1.58–10.10, p = 0.003). Only 28.8%, 43.9%, and 50.7% of patients with CKD3A, 3B, and 4 + 5 were followed up with urine investigations after discharge (p = 0.001). CKD stage 3B (OR: 3.54, CI: 1.23–10.19, p = 0.019), CKD stage 4 + 5 (OR: 6.06, CI: 1.69–21.67, p = 0.006), DM (OR: 6.28, CI: 2.38–16.58, p < 0.0001), and having been referred to a NT (OR: 20.95, CI: 3.54–123.92, p = 0.001) were independent predictors for having urine investigations.
Conclusion
The highest rate of referral was achieved in males, younger age group, and those who
have reached CKD stage 4 + 5. Urine tests remain largely underutilised and only a minority (16.4%) of patients
with an eGFR <30 mL/min/1.73 m2 were referred to a NT.
Abbreviations:
NT (Nephrology team)Keywords
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Article info
Publication history
Published online: January 19, 2016
Accepted:
January 10,
2016
Received in revised form:
December 22,
2015
Received:
June 28,
2015
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
