Chronic renal failure

factors influencing nephrology referral

I H Khan, G R Catto, N Edward, A M MacLeod

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Factors influencing referral of all 304 patients who developed persistent renal failure during one year were studied in the stable Grampian population. The annual incidence of chronic renal failure (CRF) (creatinine > or = 300 mumol/l) was 450/million of the population and of persistent advanced CRF (creatinine > or = 500 mumol/l), 132/million. After excluding those aged > 80 years and those with advanced malignancy, the corresponding incidence figures were 240/million/year and 81/million/year. Only 109 patients (35.8%) were referred to a nephrologist. Patients were divided according to age and coexisting disease into low, medium and high risk groups; 69% of CRF patients in the low, 58% in the medium, and 21% in the high risk group were referred (100%, 88% and 37%, respectively, of the patients with advanced CRF). Two-year patient survival in the low, medium and high risk groups was 100%, 63% and 27%, respectively, in referred patients, and 100%, 48% and 14%, respectively, in non-referred patients. This method of risk stratification identifies patients (particularly those with advanced CRF) likely to have a poor outcome irrespective of referral to a nephrologist. Earlier referral for interventions to delay the progress of the patients' renal and comorbid illnesses has considerable implications for future planning and funding of renal services.
Original languageEnglish
Pages (from-to)559-564
Number of pages6
JournalQJM
Volume87
Issue number9
Publication statusPublished - 1 Sep 1994

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Nephrology
Chronic Kidney Failure
Referral and Consultation
Creatinine
Kidney
Incidence
Population Dynamics
Renal Insufficiency

Keywords

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Nephrology
  • Prejudice
  • Prevalence
  • Referral and Consultation
  • Renal Replacement Therapy
  • Risk Factors
  • Scotland
  • Survival Rate

Cite this

Khan, I. H., Catto, G. R., Edward, N., & MacLeod, A. M. (1994). Chronic renal failure: factors influencing nephrology referral. QJM, 87(9), 559-564.

Chronic renal failure : factors influencing nephrology referral. / Khan, I H; Catto, G R; Edward, N; MacLeod, A M.

In: QJM, Vol. 87, No. 9, 01.09.1994, p. 559-564.

Research output: Contribution to journalArticle

Khan, IH, Catto, GR, Edward, N & MacLeod, AM 1994, 'Chronic renal failure: factors influencing nephrology referral', QJM, vol. 87, no. 9, pp. 559-564.
Khan IH, Catto GR, Edward N, MacLeod AM. Chronic renal failure: factors influencing nephrology referral. QJM. 1994 Sep 1;87(9):559-564.
Khan, I H ; Catto, G R ; Edward, N ; MacLeod, A M. / Chronic renal failure : factors influencing nephrology referral. In: QJM. 1994 ; Vol. 87, No. 9. pp. 559-564.
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