Navigation Links
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 using earlier definitions, such as referrals that were one, three or six months before dialysis was initiated.

Singh and colleagues found that in North America, increasing age was associated with late referral, with several studies showing that being over age 75 resulted in a late referral.

One study showed that even being older than 55 is associated with late referral so it is prudent to assume the risk for delayed referral increases with age, said Singh.

The researchers said that lack of provider knowledge about the appropriate timing of referral may account for more than 25 percent of late referrals.

The study has important implications for both clinicians and policy makers, said Singh. In the future, referral guidelines should be prepared in collaboration with primary care physicians, and co-management approaches for chronic kidney disease need to be explored.

Tushar Vachharajani, M.D., an interventional nephrologist at Wake Forest Baptist who was not involved in the study, said there are multiple benefits of early referral. Early treatment by a nephrologist can help slow disease progression, but even if dialysis is inevitable, an early referral gives patient and family time to plan for the treatment.

Patients need time to prepare mentally and physically for dialysis, he said. Dialysis requires a 360-degree change in lifestyle.

He also noted that end-stage kidney disease is among the most expensive to treat on a per-capital basis. Growing health care costs makes it mandatory to practice prevention before treating a problem whenever possible, he said.


'/>"/>

Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University Baptist Medical Center
Source:Eurekalert

Related medicine news :

1. Penn study finds pro-death proteins required to regulate healthy immune function
2. New study shows promise in reducing surgical risks associated with surgical bleeding
3. Study, meta-analysis examine factors associated with death from heatstroke
4. Study suggests loss of 2 types of neurons -- not just 1 -- triggers Parkinsons symptoms
5. Study says COPD testing is not measuring up
6. Preclinical study suggests organ-transplant drug may aid in lupus fight
7. Ability to cope with stress can increase good cholesterol in older white men, study finds
8. High alcohol consumption increases stroke risk, Tulane study says
9. Mailman School of Public Health study examines link between racial discrimination and substance use
10. Pitt study finds inequality in tobacco advertising
11. Stanford study highlights cost-effective method of lowering heart disease risks
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/24/2017)... ... February 24, 2017 , ... Rosica ... in thought leadership , media relations, social media, content marketing and SEO, ... be powered through Act-On, an intuitive marketing automation platform. , Rosica will now ...
(Date:2/23/2017)... ... 23, 2017 , ... On February 22, 2017 the U.S. ... to withdraw previous guidance issued by the Obama Administration requiring schools to treat ... 2016 by the Obama Administration came in response to a growing number of ...
(Date:2/23/2017)... , ... February 23, 2017 , ... The American Cleft ... ACPA’s 74th Annual Meeting. KLS is a longtime supporter of the event. , ... exhibitor and Platinum Sponsor," said Dr. Bob Havlik, 2017 ACPA President. "KLS Martin has ...
(Date:2/23/2017)... ... February 23, 2017 , ... EBSCO Information Services ... Institute for Health and Care Excellence (NICE) framework. The agreement allows purchasers ... (NHS) to search, order and purchase medical and healthcare-related content through GOBI ...
(Date:2/23/2017)... ... , ... ERT, a global data and technology company that ... leading clinical development service provider, has selected ERT’s Trial Oversight suite as its ... to an array of circumstances including the use of multiple data capture modalities ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... DUBLIN , Feb 24, 2017 Research ... Drugs Price Analysis and Strategies - 2016" report to their ... The ... provides drug pricing data and benchmarks in the global Urinary Incontinence ... What are the key drugs marketed for Urinary Incontinence ...
(Date:2/23/2017)... -- Cogentix Medical, Inc. (NASDAQ: CGNT), a medical device company ... the urology market, will release financial results for the ... before the market open on Thursday, March 9, 2017. ... call and webcast to discuss its financial results the ... a.m. Eastern Time (10:00 a.m. Central Time). Darin ...
(Date:2/23/2017)... 23, 2017 Research and Markets has announced ... Strategies - 2016" report to their offering. ... The latest research Oesophageal Cancer ... and benchmarks in the global Oesophageal Cancer market. The ... are the key drugs marketed for Oesophageal Cancer and their clinical ...
Breaking Medicine Technology: