Slowing renal function decline in chronic kidney disease patients after nephrology referral

Abstract

Slowing renal functional decline in CKD patients after referral addresses the importance of nephrology referral for CKD care, which should be strongly promoted in CKD prevention projects in Taiwan.

Influence of Nephrologist Care on Management and Outcomes in Adults with Chronic Kidney Disease

“…30 In contrast, three small studies conducted outside the U.S. found nephrology care to be associated with better kidney function preservation. [12][13][14] In two separate studies of U.S. Veterans with CKD, nephrology care was associated with a reduced risk of death, and regular frequent visits were associated with the lowest risk. 10,11 A potential explanation for these heterogeneous findings is that patients with severe terminal medical conditions (e.g.…”

“…While a few existing studies have noted that adherence to clinical guidelines is suboptimal overall, 31,32 nephrology care has been generally associated with better control of hypertension, anemia, and calcium-phosphorus metabolism. [12][13][14][33][34][35] However, others have not observed a benefit of nephrology care on these parameters and have found such care to vary substantially among nephrologists. 11,36 Several reasons may account for our observations.…”

“…Several studies have shown that outpatient nephrology care may result in slowing kidney function decline and/or improving survival. [10][11][12][13][14] However, these reports are limited by small sample sizes, lack of racial/ ethnicity diversity, retrospective design or short duration of follow-up. The purpose of this study was to characterize current patterns of nephrology care and to examine the effect of nephrology care on management of CKD risk factors and complications, CKD progression, incident cardiovascular disease (CVD), and death among Chronic Renal Insufficiency Cohort (CRIC) Study participants.…”

The impact of introducing automated eGFR reporting on uncovering new cases of chronic kidney disease in a University Hospital in Saudi Arabia

“…For new referrals with CKD stages 3-5, the rates of annual eGFR decline slowed from À7.38 before referral to À1.02 mL/min after referral (p50.001). 1,2 In fact, in patients with diabetic nephropathy, an increase in eGFR was noted compared to those without diabetes (p ¼ 0.034). 1 The risk of mortality increases with delay in referral.…”

“…1,2 In fact, in patients with diabetic nephropathy, an increase in eGFR was noted compared to those without diabetes (p ¼ 0.034). 1 The risk of mortality increases with delay in referral. 3 Compared with early referral patients, late referral patients had a 44% higher risk of death at 1 year after initiation of dialysis (HR, 1.44; 95% CI, 1.15-1.80).…”