Reports From the Field: Delayed evaluations increase risk for kidney patients
Kidney patients are at a greatly increased risk of death when they have delays getting to a specialist, researchers at Johns Hopkins University in Baltimore have concluded.1
The study shows that a nephrologist evaluated a third of chronic kidney disease patients only four months before having to start dialysis treatment. Those evaluated late were more likely to die within two years.
Delayed in getting specialty care probably can be attributed to poor access to primary care, delayed or absent referral to a specialists from a primary care physician, and patients’ lack of information about the importance of early intervention, says Neil R. Powe, MD, MPH, MBA, senior author of the study.
Powe and his colleagues examined data from Choices for Healthy Outcomes in Caring for End-stage renal disease, a study at Hopkins that followed more than 1,000 dialysis patients.
Among the patients who were evaluated late, 13% died one year after starting dialysis, and 27% died two years after starting dialysis. By contrast, patients who were evaluated early had death rates of 4% after the first year and 15% after the second year.
Reference
1. Kinchen KS, Sadler J, Fink N. The timing of specialist intervention in chronic kidney disease and mortality. Ann Intern Med 2002; 137(6):479-86.
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