Motifs de primo-consultations de néphrologie en 2014 dans le territoire de santé 5 de Bretagne

Prévot, Jeanne; Bayat-Makoei, Sahar; Vigneau, Cécile

doi:10.1016/j.nephro.2016.09.003

Cited by 1 publication

(1 citation statement)

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“…The Canadian study by Akbari et al, describing patients seen by a nephrologist for the first time, reported approximately 60% of patients seen in stage G3, 20% in stages G1-2 and 20% in stages G4-5, in accordance with our practice [17]. In addition, the French study by Prévot et al [21] reported 70% of patients with CKD as the reason for first nephrology consultations. This was similar to our population, but about 20% of these patients had a GFR > 45 ml/min and a PCR < 0.5 g/g, and 16% were classified as having no CKD, thus 36% had no theoretical indication for consultation, which was less than in our population.…”

Section: Discussionmentioning

confidence: 68%

Characteristics of outpatients referred for a first consultation with a nephrologist: impact of different guidelines

et al. 2022

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Introduction Chronic kidney disease (CKD) affects > 10% of the population but not all CKD patients require referral to a nephrologist. Various recommendations for referral to nephrologists are proposed worldwide. We examined the profile of French patients consulting a nephrologist for the first time and compared these characteristics with the recommendations of the International Kidney Disease: Improving Global Outcomes (KDIGO), the French "Haute Autorité de Santé" (HAS), and the Canadian Kidney Failure Risk Equation (KFRE). Methods University Hospital electronic medical records were used to study patients referred for consultation with a nephrologist for the first time from 2016 to 2018. Patient characteristics (age, sex, diabetic status, estimated glomerular filtration rate (eGFR) and urine protein-to-creatinine ratio (PCR), etiology reported by the nephrologist) and 1-year patient follow-up were analyzed and compared with the KDIGO, HAS and Canadian-KFRE recommendations for referral to a nephrologist. The stages were defined according to the KDIGO classification, based upon kidney function and proteinuria. ResultsThe 1,547 included patients had a median age of 71 [61-79] years with 56% males and 37% with diabetes. The main nephropathies were vascular (40%) and glomerular (20%). The KDIGO classification revealed 30%, 47%, 19%, 4% stages G1-2 to G5, and 50%, 22%, 28% stages A1-A3, respectively. According to KDIGO, HAS and KFRE scores, nephrologist referral was indicated for 42%, 57% and 80% of patients respectively, with poor agreement between recommendations. Furthermore, we observed 890 (57%) patients with an eGFR> 30 ml/min and a urine protein to creatinine ratio 0.5 g/g, mostly aged over 65 years (67%); 40% were diabetic, and 57% had a eGFR > 45 ml/min/1.73m 2 , 56% were diagnosed as vascular nephropathy and 11% with unknown nephropathy. Conclusion These results underline the importance of better identifying patients for referral to a nephrologist and informing general practitioners. Other referral criteria (age and etiology of the nephropathy) are debatable.

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Section: Discussionmentioning

confidence: 68%