ArticleCanadian journal of kidney health and disease2017
Risk-Based Triage for Nephrology Referrals Using the Kidney Failure Risk Equation.
Article in Canadian journal of kidney health and disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 1 of them a synthesis that pooled it.
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Who cites it
60 citing papers in PubMed, 1 synthesis or guideline pooled it, 99 citations in OpenAlex.
- Pooled it
- Article
- Risk-based referral model to nephrologist specialist care in Stockholm.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Observational
- Clinical and Financial Impacts of Late Referral in Patients With Chronic Kidney Disease: A Narrative Review.Cureus · 2025Review
- Awareness and management of stage 3 chronic kidney disease among primary care practitioners in Italy: a nation-wide observational study.Journal of nephrology · 2025Observational
- Risk of Progression and Costs of Care for Patients with Type 2 Diabetes and Chronic Kidney Disease.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Kidney Failure Risk Equation performance according to the etiology of chronic kidney disease in the CKD-CAREMEAU cohort.Clinical kidney journal · 2025Article
- Risk Stratification for CKD Progression in Primary Care.Kidney international reports · 2025Article
- Analysis of the kidney failure risk equation implementation in routine clinical practice and health inequalities in chronic kidney disease care: a retrospective cohort study.BMC nephrology · 2025Article
- KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease in Children and Adults: a commentary from the European Renal Best Practice (ERBP).Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Article
- Chronic Kidney Disease in Balkan Countries-A Call for Optimal Multidisciplinary Management.International journal of environmental research and public health · 2025Review
- Initiatives to enhance referral patterns from primary care to specialist kidney care:a systematic review and meta-analysis.BMJ public health · 2025Article
- Enhancing vascular access planning in CKD: validating the 40% KFRE threshold for predicting ESKD in a French retrospective cohort study.Clinical kidney journal · 2024Article
- External Validation of the Kidney Failure Risk Equation Among Urban Community-Based Chinese Patients With CKD.Kidney medicine · 2024Article
- Primary and specialist care interaction and referral patterns for individuals with chronic kidney disease: a narrative review.BMC nephrology · 2024Review
- Predicting the risks of kidney failure and death in adults with moderate to severe chronic kidney disease: multinational, longitudinal, population based, cohort study.BMJ (Clinical research ed.) · 2024Article
- External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease.Journal of nephrology · 2024Article
- Risk Prediction and Management of Chronic Kidney Disease in People Living with Type 2 Diabetes Mellitus.Diabetes & metabolism journal · 2024Review
- Recalibrating the kidney failure risk equation for a Mediterranean European population: reducing age and sex inequality.Frontiers in medicine · 2024Article
- Clinical Decision Support Tools in the Electronic Medical Record.Kidney international reports · 2024Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn some jurisdictions, routine reporting of the estimated glomerular filtration rate (eGFR) has led to an increase in nephrology referrals and wait times.
objectiveWe describe the use of the Kidney Failure Risk Equation (KFRE) as part of a triage process for new nephrology referrals for patients with chronic kidney disease stages 3 to 5 in a Canadian province.
designA quasi-experimental study design was used.
settingThis study took place in Manitoba, Canada. MEASUREMENTS: Demographics, laboratory values, referral numbers, and wait times were compared between periods.
methodsIn 2012, we adopted a risk-based cutoff of 3% over 5 years using the KFRE as a threshold for triage of new referrals. Referrals who did not meet other prespecified criteria (such as pregnancy, suspected glomerulonephritis, etc) and had a kidney failure risk of <3% over 5 years were returned to primary care with recommendations based on diabetes and hypertension guidelines. The average wait time and number of consults seen between the pretriage (January 1, 2011, to December 31, 2011) and posttriage period (January 1, 2013, to December 31, 2013) were compared using a general linear model.
resultsIn the pretriage period, the median number of referrals was 68/month (range: 44-76); this increased to 94/month (range: 61-147) in the posttriage period. In the posttriage period, 35% of referrals were booked as urgent, 31% as nonurgent, and 34% of referrals were not booked. The median wait times improved from 230 days (range: 126-355) in the pretriage period to 58 days (range: 48-69) in the posttriage period. LIMITATIONS: We do not have long-term follow-up on patients triaged as low risk. Our study may not be applicable to nephrology teams operating under capacity without wait lists. We did not collect detailed information on all referrals in the pretriage period, so any differences in our pretriage and posttriage patient groups may be unaccounted for.
conclusionsOur risk-based triage scheme is an effective health policy tool that led to improved wait times and access to care for patients at highest risk of progression to kidney failure.
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