Evidence map›Paper›PMID 34011302›Full record

ArticleBMC nephrology2021

Referring patients with chronic kidney disease back to primary care: a criteria-based analysis in outpatient renal clinics.

Carola van Dipten, Davy Gerda Hermina Antoin van Dam, Wilhelmus Joannes Carolus de Grauw, Marcus Antonius Gerard Jan Ten Dam, Marcus Matheus Hendrik Hermans, Willem Jan Jozef Assendelft, Nynke Dorothea Scherpbier-de Haan, Jacobus Franciscus Maria Wetzels

Abstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Review
  4. Article
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Carola van DiptenDepartment of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Geert Grooteplein Noord 2, postal route 117, 6525, EZ, Nijmegen, The Netherlands. Carola.vanDipten@radboudumc.nl.
Davy Gerda Hermina Antoin van DamDepartment of Internal medicine, Viecuri Medical Center, Tegelseweg 210, 5912, BL, Venlo, The Netherlands.
Wilhelmus Joannes Carolus de GrauwDepartment of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Geert Grooteplein Noord 2, postal route 117, 6525, EZ, Nijmegen, The Netherlands.
Marcus Antonius Gerard Jan Ten DamDepartment of Internal medicine, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532, SZ, Nijmegen, The Netherlands.
Marcus Matheus Hendrik HermansDepartment of Internal medicine, Viecuri Medical Center, Tegelseweg 210, 5912, BL, Venlo, The Netherlands.
Willem Jan Jozef AssendelftDepartment of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Geert Grooteplein Noord 2, postal route 117, 6525, EZ, Nijmegen, The Netherlands.
Nynke Dorothea Scherpbier-de HaanDepartment of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Geert Grooteplein Noord 2, postal route 117, 6525, EZ, Nijmegen, The Netherlands.
Jacobus Franciscus Maria WetzelsDepartment of Nephrology, Radboud Institute for Health Sciences, Radboud university medical center, Geert Grooteplein Zuid 8, postal route 464, 525, GA, Nijmegen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe increased demand for nephrology care for patients with chronic kidney disease (CKD) necessitates a critical review of the need for secondary care facilities and the possibilities for referral back to primary care. This study aimed to evaluate the characteristics and numbers of patients who could potentially be referred back to primary care, using predefined criteria developed by nephrologists and general practitioners.

methodWe organised a consensus meeting with eight nephrologists and two general practitioners to define the back referral (BR) criteria, and performed a retrospective cohort study reviewing records from patients under nephrologist care in three hospitals.

resultsWe reached a consensus about the BR criteria. Overall, 78 of the 300 patients (26%) in the outpatient clinics met the BR criteria. The characteristics of the patients who met the BR criteria were: 56.4% male, a median age of 70, an average of 3.0 outpatients visits per year, and a mean estimated glomerular filtration rate of 46 ml/min/1,73m

conclusionA substantial proportion of patients were eligible for referral back to primary care. These patients often have a comorbidity, such as hypertension or diabetes. Future research should focus on generalisability of the BR criteria, the feasibility of actual implementation of the back referral, follow-up assessments of renal function and patient satisfaction.

Indexed as

Primary Health CareReferral and ConsultationAdultAgedAged, 80 and overAmbulatory Care FacilitiesFemaleGlomerular Filtration RateHumansMaleMiddle AgedRenal Insufficiency, ChronicRetrospective StudiesRisk FactorsBack referralChronic kidney diseasePrimary careRetrospective cohort studyShared care

Identifiers

PMID34011302
PMCPMC8136153

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.