2007
DOI: 10.1016/j.amjmed.2007.04.024
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Outcomes in Patients with Chronic Kidney Disease Referred Late to Nephrologists: A Meta-analysis

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Cited by 171 publications
(135 citation statements)
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“…In a significant number of cases, CKD patients are referred to nephrologists much later than it would deem appropriate [32]. Late evaluation of CKD patients by nephrologists, especially those presenting in Stage 5 CKD, is associated with suboptimal pre-dialysis care and increased mortality [33][34][35]. This is especially pertinent to developing countries, where support for renal replacement therapy is constrained for the vast majority of ESRD patients by cost and lack of technological advancements [36].…”
Section: Discussionmentioning
confidence: 99%
“…In a significant number of cases, CKD patients are referred to nephrologists much later than it would deem appropriate [32]. Late evaluation of CKD patients by nephrologists, especially those presenting in Stage 5 CKD, is associated with suboptimal pre-dialysis care and increased mortality [33][34][35]. This is especially pertinent to developing countries, where support for renal replacement therapy is constrained for the vast majority of ESRD patients by cost and lack of technological advancements [36].…”
Section: Discussionmentioning
confidence: 99%
“…In the last two decades, several uncontrolled or retrospective studies have underlined the clinical and economic advantages of timely referral to nephrology (20)(21)(22)(23). However, as highlighted by current guidelines (4), the referral recommendations still remain inconsistent.…”
Section: Discussionmentioning
confidence: 99%
“…17 In support of these guidelines are observational data in both the veteran and general populations suggesting that early nephrology referral may improve outcomes in patients with moderate to severe CKD. 15,22,23 Tseng et al 15 demonstrated that consistent outpatient nephrology care in patients with diabetes and stage III-IV CKD associates with an adjusted 20%-55% reduction in mortality. Although the care elements driving this observed benefit are not fully understood, better recognition and control of both traditional cardiovascular risk factors and secondary complications of CKD are likely contributors.…”
Section: Discussionmentioning
confidence: 99%