ArticleJournal of nephrology2022
Characteristics of outpatients referred for a first consultation with a nephrologist: impact of different guidelines.
Article in Journal of nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Challenges and strategies for managing early-to-moderate chronic kidney disease in primary care: A systematic integrative review in high-income countries.The European journal of general practice · 2026Pooled it
- Ten tips for kidney biopsy in cancer patients.Clinical kidney journal · 2026Review
- Registry of access to chronic dialysis initiation at the Public Health System in Brazil.International urology and nephrology · 2026Article
- Kidney health outcomes of hypertensive disorders of pregnancy.Nature reviews. Nephrology · 2025Review
- Kidney Failure Risk Equation performance according to the etiology of chronic kidney disease in the CKD-CAREMEAU cohort.Clinical kidney journal · 2025Article
- Performance of the Kidney Failure Risk Equation according to diabetic status in the CKD-CAREMEAU cohort of patients with chronic kidney disease.Journal of nephrology · 2025Article
- Kidney diseases are recognized as a priority: political victory or clinical failure?Journal of nephrology · 2025Article
- Green, Sustainable Nephrology: State of the Art Needs for Education and Implementation.Clinical journal of the American Society of Nephrology : CJASN · 2025Review
- The 60:40 conundrum: are women with CKD discriminated after referral to a nephrology clinic?Clinical kidney journal · 2025Article
- Navigating the Challenge - the Quest for Effective CKD Screening: ethical and practical issues, and environmental sustainability.Journal of nephrology · 2024Article
- General practitioners' representation of early-stage CKD is a barrier to adequate management and patient empowerment: a phenomenological study.Journal of nephrology · 2024Article
- Key Performance Indicators of Secondary Health Care in Chronic Kidney Disease: Experience in Public and Private Services in the State of São Paulo, Brazil.International journal of nephrology · 2024Article
- Risk-based versus GFR threshold criteria for nephrology referral in chronic kidney disease.Clinical kidney journal · 2022Review
- Qualitative approach to better understand the trajectory of patients with early and moderate stage CKD.Clinical kidney journal · 2022Article
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionChronic kidney disease (CKD) affects > 10% of the population but not all CKD patients require referral to a nephrologist. Various recommendations for referral to nephrologists are proposed worldwide. We examined the profile of French patients consulting a nephrologist for the first time and compared these characteristics with the recommendations of the International Kidney Disease: Improving Global Outcomes (KDIGO), the French "Haute Autorité de Santé" (HAS), and the Canadian Kidney Failure Risk Equation (KFRE).
methodsUniversity Hospital electronic medical records were used to study patients referred for consultation with a nephrologist for the first time from 2016 to 2018. Patient characteristics (age, sex, diabetic status, estimated glomerular filtration rate (eGFR) and urine protein-to-creatinine ratio (PCR), etiology reported by the nephrologist) and 1-year patient follow-up were analyzed and compared with the KDIGO, HAS and Canadian-KFRE recommendations for referral to a nephrologist. The stages were defined according to the KDIGO classification, based upon kidney function and proteinuria.
resultsThe 1,547 included patients had a median age of 71 [61-79] years with 56% males and 37% with diabetes. The main nephropathies were vascular (40%) and glomerular (20%). The KDIGO classification revealed 30%, 47%, 19%, 4% stages G1-2 to G5, and 50%, 22%, 28% stages A1-A3, respectively. According to KDIGO, HAS and KFRE scores, nephrologist referral was indicated for 42%, 57% and 80% of patients respectively, with poor agreement between recommendations. Furthermore, we observed 890 (57%) patients with an eGFR> 30 ml/min and a urine protein to creatinine ratio 0.5 g/g, mostly aged over 65 years (67%); 40% were diabetic, and 57% had a eGFR > 45 ml/min/1.73m
conclusionThese results underline the importance of better identifying patients for referral to a nephrologist and informing general practitioners. Other referral criteria (age and etiology of the nephropathy) are debatable.
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