Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea.
The timing of referral to a nephrologist may influence the outcome of chronic kidney disease patients, but its impact has not been evaluated thoroughly. The results of a recent study showing an association between early referral and patient survival are still being debated. A total of 1028 patients...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3555934?pdf=render |
| _version_ | 1811208827660402688 |
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| author | Do Hyoung Kim Myounghee Kim Ho Kim Yong-Lim Kim Shin-Wook Kang Chul Woo Yang Nam-Ho Kim Yon Su Kim Jung Pyo Lee |
| author_facet | Do Hyoung Kim Myounghee Kim Ho Kim Yong-Lim Kim Shin-Wook Kang Chul Woo Yang Nam-Ho Kim Yon Su Kim Jung Pyo Lee |
| author_sort | Do Hyoung Kim |
| collection | DOAJ |
| description | The timing of referral to a nephrologist may influence the outcome of chronic kidney disease patients, but its impact has not been evaluated thoroughly. The results of a recent study showing an association between early referral and patient survival are still being debated. A total of 1028 patients newly diagnosed as end-stage renal disease (ESRD) from July 2008 to October 2011 were enrolled. Early referral (ER) was defined as patients meeting with a nephrologist more than a year before dialysis and dialysis education were provided, and all others were considered late referral (LR). The relationship of referral pattern with mortality in ESRD patients was explored using a Cox proportional hazards regression models. Time from referral to dialysis was significantly longer in 599 ER patients than in 429 LR patients (62.3 ± 58.9 versus 2.9 ± 3.4 months, P<0.001). Emergency HD using a temporary vascular catheter was required in 485 (47.2%) out of all patients and in 262 (43.7%) of ER compared with 223 (52.0%) of LR (P = 0.009). After 2 years of follow-up, the survival rate in ER was better than that in LR (hazard ratio [HR] 2.38, 95% confidence interval [CI] 1.27-4.45, P = 0.007). In patients with diabetes nephropathy, patient survival was also significantly higher in ER than in LR (HR 4.74, 95% CI 1.73-13.00, P = 0.002). With increasing age, HR also increased. Timely referral to a nephrologist in the predialytic stage is associated with reduced mortality. |
| first_indexed | 2024-04-12T04:28:16Z |
| format | Article |
| id | doaj.art-c5edcbac938f46d99a823b29b54203ac |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T04:28:16Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c5edcbac938f46d99a823b29b54203ac2022-12-22T03:48:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0181e5532310.1371/journal.pone.0055323Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea.Do Hyoung KimMyounghee KimHo KimYong-Lim KimShin-Wook KangChul Woo YangNam-Ho KimYon Su KimJung Pyo LeeThe timing of referral to a nephrologist may influence the outcome of chronic kidney disease patients, but its impact has not been evaluated thoroughly. The results of a recent study showing an association between early referral and patient survival are still being debated. A total of 1028 patients newly diagnosed as end-stage renal disease (ESRD) from July 2008 to October 2011 were enrolled. Early referral (ER) was defined as patients meeting with a nephrologist more than a year before dialysis and dialysis education were provided, and all others were considered late referral (LR). The relationship of referral pattern with mortality in ESRD patients was explored using a Cox proportional hazards regression models. Time from referral to dialysis was significantly longer in 599 ER patients than in 429 LR patients (62.3 ± 58.9 versus 2.9 ± 3.4 months, P<0.001). Emergency HD using a temporary vascular catheter was required in 485 (47.2%) out of all patients and in 262 (43.7%) of ER compared with 223 (52.0%) of LR (P = 0.009). After 2 years of follow-up, the survival rate in ER was better than that in LR (hazard ratio [HR] 2.38, 95% confidence interval [CI] 1.27-4.45, P = 0.007). In patients with diabetes nephropathy, patient survival was also significantly higher in ER than in LR (HR 4.74, 95% CI 1.73-13.00, P = 0.002). With increasing age, HR also increased. Timely referral to a nephrologist in the predialytic stage is associated with reduced mortality.http://europepmc.org/articles/PMC3555934?pdf=render |
| spellingShingle | Do Hyoung Kim Myounghee Kim Ho Kim Yong-Lim Kim Shin-Wook Kang Chul Woo Yang Nam-Ho Kim Yon Su Kim Jung Pyo Lee Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. PLoS ONE |
| title | Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. |
| title_full | Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. |
| title_fullStr | Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. |
| title_full_unstemmed | Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. |
| title_short | Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. |
| title_sort | early referral to a nephrologist improved patient survival prospective cohort study for end stage renal disease in korea |
| url | http://europepmc.org/articles/PMC3555934?pdf=render |
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