Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study identifies reasons patients referred late to nephrologists

04.03.2008
Some patients with kidney disease aren’t referred to kidney specialists in time to delay disease progression and improve their prognosis for a variety of reasons, according to researchers at Wake Forest University School of Medicine and colleagues.

An analysis of 18 separate studies found that overall, being older, belonging to a minority group, being uninsured and suffering from multiple health problems are patient characteristics associated with late referral. In addition, a lack of communication between referring physicians and nephrologists also contribute to the problem. The findings were published online this week by BioMed Central Nephrology.

Research has shown that the progression from chronic to end-stage kidney disease, which requires dialysis treatments, can be slowed if kidney damage is detected and treated early. Care by nephrologists, who specialize in treating kidney disease, is associated with reduced rates of hospitalization and death. However, studies indicate that up to 80 percent of patients who start dialysis are referred late to nephrologists.

“Late referral has been documented as a problem for more than 15 years and, according to recent studies, is not declining,” said Sonal Singh, M.D., senior author and an assistant professor of general internal medicine. “Finding ways to address the problem has been hampered by a lack of understanding of the factors responsible.”

About 26 million Americans suffer from chronic kidney disease and it is estimated that there will be 700,000 cases of end-stage kidney disease by 2015. The National Kidney Foundation recommends that patients with kidney disease be referred to nephrologists when they reach stage 4, which is a severe decrease in kidney function.

The researchers analyzed 18 studies on late referrals and looked for trends in results. They included studies that used the National Kidney Foundation’s definition of “late” as well as studies using earlier definitions, such as referrals that were one, three or six months before dialysis was initiated.

Singh and colleagues found that in North America, increasing age was associated with late referral, with several studies showing that being over age 75 resulted in a late referral.

“One study showed that even being older than 55 is associated with late referral so it is prudent to assume the risk for delayed referral increases with age,” said Singh.

The researchers said that lack of provider knowledge about the appropriate timing of referral may account for more than 25 percent of late referrals.

“The study has important implications for both clinicians and policy makers,” said Singh. “In the future, referral guidelines should be prepared in collaboration with primary care physicians, and co-management approaches for chronic kidney disease need to be explored.”

Tushar Vachharajani, M.D., an interventional nephrologist at Wake Forest Baptist who was not involved in the study, said there are multiple benefits of early referral. Early treatment by a nephrologist can help slow disease progression, but even if dialysis is inevitable, an early referral gives patient and family time to plan for the treatment.

“Patients need time to prepare mentally and physically for dialysis,” he said. “Dialysis requires a 360-degree change in lifestyle.”

He also noted that end-stage kidney disease is among the most expensive to treat on a per-capital basis. “Growing health care costs makes it mandatory to practice prevention before treating a problem whenever possible,” he said.

Karen Richardson | EurekAlert!
Further information:
http://www.wfubmc.edu

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Strathclyde-led research develops world's highest gain high-power laser amplifier

The world's highest gain high power laser amplifier - by many orders of magnitude - has been developed in research led at the University of Strathclyde.

The researchers demonstrated the feasibility of using plasma to amplify short laser pulses of picojoule-level energy up to 100 millijoules, which is a 'gain'...

Im Focus: Can the immune system be boosted against Staphylococcus aureus by delivery of messenger RNA?

Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.

Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....

Im Focus: A quantum walk of photons

Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.

The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Marine Conservation: IASS Contributes to UN Ocean Conference in New York on 5-9 June

24.05.2017 | Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

 
Latest News

Camera on NASA's Lunar Orbiter survived 2014 meteoroid hit

29.05.2017 | Physics and Astronomy

Strathclyde-led research develops world's highest gain high-power laser amplifier

29.05.2017 | Physics and Astronomy

A 3-D look at the 2015 El Niño

29.05.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>