Tags

Type your tag names separated by a space and hit enter

Timing of nephrology referral: influence on mortality and morbidity.
Am J Kidney Dis. 2000 Jul; 36(1):35-41.AJ

Abstract

To assess the influence of the timing of nephrology referral on the short- and long-term outcome of hemodialysis patients, we retrospectively studied 309 patients who had end-stage renal failure and entered the chronic hemodialysis program in Sainte-Marguerite University Hospital between January 1, 1989, and December 31, 1996. We excluded from the analysis five patients without available data on referral pattern and 34 patients with irreversible acute renal failure. Of the remaining 270 patients, 177 patients (58%) had an early referral (ER) 16 or more weeks before the start of dialysis, and 93 patients (31%) had a late referral (LR) of less than 16 weeks before dialysis. Short-time morbidity (initial emergent dialysis, pulmonary edema, severe hypertension, temporary vascular access placement for first dialysis, prolonged initial hospitalization) was significantly more frequent in LR patients. Long-term evolution (mean follow-up, 26.5 +/- 26 months) did not differ between the two groups. The number of days of hospitalization per patient-year at risk beyond the third month was 21.5 +/- 33.7 days for ER and 21.1 +/- 36 days for LR patients. Survival analysis showed no difference between the two groups: 3-month survival rates were 96% in both groups, 1-year survival rates were 90% in the ER and 89% in the LR group, and 5-year survival rates were 52% in the ER and 56% in the LR group. In a Cox hazards regression model, referral pattern was not associated with a greater risk for death. In conclusion, delayed nephrology referral generated strikingly greater initial morbidity, but long-term outcome of hemodialysis patients was not modified by delayed nephrological care.

Authors+Show Affiliations

Service de Néphrologie et Hémodialyse, Département d'Information Médicale, Hôpital Sainte Marguerite, Marseille, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10873869

Citation

Roubicek, C, et al. "Timing of Nephrology Referral: Influence On Mortality and Morbidity." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 36, no. 1, 2000, pp. 35-41.
Roubicek C, Brunet P, Huiart L, et al. Timing of nephrology referral: influence on mortality and morbidity. Am J Kidney Dis. 2000;36(1):35-41.
Roubicek, C., Brunet, P., Huiart, L., Thirion, X., Leonetti, F., Dussol, B., Jaber, K., Andrieu, D., Ramananarivo, P., & Berland, Y. (2000). Timing of nephrology referral: influence on mortality and morbidity. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 36(1), 35-41.
Roubicek C, et al. Timing of Nephrology Referral: Influence On Mortality and Morbidity. Am J Kidney Dis. 2000;36(1):35-41. PubMed PMID: 10873869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Timing of nephrology referral: influence on mortality and morbidity. AU - Roubicek,C, AU - Brunet,P, AU - Huiart,L, AU - Thirion,X, AU - Leonetti,F, AU - Dussol,B, AU - Jaber,K, AU - Andrieu,D, AU - Ramananarivo,P, AU - Berland,Y, PY - 2000/6/30/pubmed PY - 2000/6/30/medline PY - 2000/6/30/entrez SP - 35 EP - 41 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 36 IS - 1 N2 - To assess the influence of the timing of nephrology referral on the short- and long-term outcome of hemodialysis patients, we retrospectively studied 309 patients who had end-stage renal failure and entered the chronic hemodialysis program in Sainte-Marguerite University Hospital between January 1, 1989, and December 31, 1996. We excluded from the analysis five patients without available data on referral pattern and 34 patients with irreversible acute renal failure. Of the remaining 270 patients, 177 patients (58%) had an early referral (ER) 16 or more weeks before the start of dialysis, and 93 patients (31%) had a late referral (LR) of less than 16 weeks before dialysis. Short-time morbidity (initial emergent dialysis, pulmonary edema, severe hypertension, temporary vascular access placement for first dialysis, prolonged initial hospitalization) was significantly more frequent in LR patients. Long-term evolution (mean follow-up, 26.5 +/- 26 months) did not differ between the two groups. The number of days of hospitalization per patient-year at risk beyond the third month was 21.5 +/- 33.7 days for ER and 21.1 +/- 36 days for LR patients. Survival analysis showed no difference between the two groups: 3-month survival rates were 96% in both groups, 1-year survival rates were 90% in the ER and 89% in the LR group, and 5-year survival rates were 52% in the ER and 56% in the LR group. In a Cox hazards regression model, referral pattern was not associated with a greater risk for death. In conclusion, delayed nephrology referral generated strikingly greater initial morbidity, but long-term outcome of hemodialysis patients was not modified by delayed nephrological care. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/10873869/Timing_of_nephrology_referral:_influence_on_mortality_and_morbidity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(00)37130-X DB - PRIME DP - Unbound Medicine ER -