Predialysis Issues
Kidney International (2002) 61, S27–S34; doi:10.1046/j.1523-1755.61.s80.6.x
An update on the referral pattern of patients with end-stage renal disease
Norbert Lameire1, Jean-Pierre Wauters, Jose Luis Górriz Teruel, Wim Van Biesen and Raymond Vanholder
Renal Division, University Hospital, Ghent, Belgium; Division of Nephrology, University Hospital/CHUV, Lausanne, Switzerland; and Servicio de Nefrología, Hospital Universitario, Dr. Peset., Valencia, Spain
Correspondence: Norbert Lameire, M.D., University Hospital, 185 De Pintelaan, 9000 Ghent Belgium. E-mail: ingrid.verslychen@rug.ac.be
1Present address: University Hospital, 185, De Pintelaan, 9000 Ghent, Belgium.
Abstract
An update on the referral pattern of patients with end-stage renal disease. This article first describes the epidemiology and reasons of late referal to the nephrologist of patients suffering from end-stage renal disease (ESRD). Depending on the definition, between 25 and 50% of worldwide ESRD patients are referred very late. Second, the relation of late referral to the quality of pre-ESRD care, its impact on the selection of dialysis modality, on the time of start of dialysis and on the use of an adequate vascular access, are discussed. Finally, the economic aspects of late referral are described and ways to improve the referral pattern are proposed.
Keywords:
patient referral, pre-ESRD care, vascular access, dialysis initiation
