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Study identifies reasons patients referred late to nephrologists
Date:2/29/2008

WINSTON-SALEM, N.C. Some patients with kidney disease arent referred to kidney specialists in time to delay disease progression and improve their prognosis for a variety of reasons, according to researchers at Wake Forest University School of Medicine and colleagues.

An analysis of 18 separate studies found that overall, being older, belonging to a minority group, being uninsured and suffering from multiple health problems are patient characteristics associated with late referral. In addition, a lack of communication between referring physicians and nephrologists also contribute to the problem. The findings were published online this week by BioMed Central Nephrology.

Research has shown that the progression from chronic to end-stage kidney disease, which requires dialysis treatments, can be slowed if kidney damage is detected and treated early. Care by nephrologists, who specialize in treating kidney disease, is associated with reduced rates of hospitalization and death. However, studies indicate that up to 80 percent of patients who start dialysis are referred late to nephrologists.

Late referral has been documented as a problem for more than 15 years and, according to recent studies, is not declining, said Sonal Singh, M.D., senior author and an assistant professor of general internal medicine. Finding ways to address the problem has been hampered by a lack of understanding of the factors responsible.

About 26 million Americans suffer from chronic kidney disease and it is estimated that there will be 700,000 cases of end-stage kidney disease by 2015. The National Kidney Foundation recommends that patients with kidney disease be referred to nephrologists when they reach stage 4, which is a severe decrease in kidney function.

The researchers analyzed 18 studies on late referrals and looked for trends in results. They included studies that used the National Kidney Foundations definition of late as well as studies
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Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University Baptist Medical Center
Source:Eurekalert

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