Evidence map›Paper›PMID 38689219›Full record

ReviewBMC nephrology2024

Primary and specialist care interaction and referral patterns for individuals with chronic kidney disease: a narrative review.

Clyson Mutatiri, Angela Ratsch, Matthew McGrail, Sree Krishna Venuthurupalli, Srinivas Kondalsamy Chennakesavan

Open access · goldAbstract readReview
In one paragraph

Review in BMC nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.4field-weighted citation impact, top 10% of its field
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

4 citing papers in PubMed, 7 citations in OpenAlex.

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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

5 authors at 2 institutions in 1 country.

Clyson MutatiriRenal Medicine, Wide Bay Hospital and Health Service, Bundaberg, QLD, Australia. clyson.mutatiri@health.qld.gov.au.
Angela RatschResearch Services, Wide Bay Hospital and Health Service, Hervey Bay, QLD, Australia.
Matthew McGrailRural Clinical School, Faculty of Medicine, The University of Queensland, Rockhampton, QLD, Australia.
Sree Krishna VenuthurupalliKidney Service, Department of Medicine, West Moreton Hospital and Health Service, Ipswich, QLD, Australia.
Srinivas Kondalsamy ChennakesavanRural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
University of Queensland · AUIpswich Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely referral of individuals with chronic kidney disease from primary care to secondary care is evidenced to improve patient outcomes, especially for those whose disease progresses to kidney failure requiring kidney replacement therapy. A shortage of specialist nephrology services plus no consistent criteria for referral and reporting leads to referral pattern variability in the management of individuals with chronic kidney disease.

objectiveThe objective of this review was to explore the referral patterns of individuals with chronic kidney disease from primary care to specialist nephrology services. It focused on the primary-specialist care interface, optimal timing of referral to nephrology services, adequacy of preparation for kidney replacement therapy, and the role of clinical criteria vs. risk-based prediction tools in guiding the referral process.

methodsA narrative review was utilised to summarise the literature, with the intent of providing a broad-based understanding of the referral patterns for patients with chronic kidney disease in order to guide clinical practice decisions. The review identified original English language qualitative, quantitative, or mixed methods publications as well as systematic reviews and meta-analyses available in PubMed and Google Scholar from their inception to 24 March 2023.

resultsThirteen papers met the criteria for detailed review. We grouped the findings into three main themes: (1) Outcomes of the timing of referral to nephrology services, (2) Adequacy of preparation for kidney replacement therapy, and (3) Comparison of clinical criteria vs. risk-based prediction tools. The review demonstrated that regardless of the time frame used to define early vs. late referral in relation to the start of kidney replacement therapy, better outcomes are evidenced in patients referred early.

conclusionsThis review informs the patterns and timing of referral for pre-dialysis specialist care to mitigate adverse outcomes for individuals with chronic kidney disease requiring dialysis. Enhancing current risk prediction equations will enable primary care clinicians to accurately predict the risk of clinically important outcomes and provide much-needed guidance on the timing of referral between primary care and specialist nephrology services.

Indexed as

NephrologyPrimary Health CareReferral and ConsultationRenal Insufficiency, ChronicHumansRenal Replacement TherapySpecializationAdequacy of pre-dialysis careChronic kidney diseaseTiming of referral

Identifiers

PMID38689219
PMCPMC11061991
OpenAlexW4396515218

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.