The first appointment with a nephrologist: Brazilian patients' demographic and kidney function characteristics. A retrospective study
São Paulo med. j
; 140(3): 366-371, May-June 2022. tab
Article
in En
| LILACS
| ID: biblio-1377381
Responsible library:
BR1.1
ABSTRACT
ABSTRACT BACKGROUND:
The number of nephrologists has risen slowly, compared with the prevalence of chronic kidney disease (CKD) in Brazil. Data on patients referred to nephrology outpatient clinics remains scarce.OBJECTIVE:
To determine the demographic and kidney function characteristics of patients at their first appointment with a nephrologist. DESIGN ANDSETTING:
Retrospective study conducted at three nephrology outpatient clinics (public and private services), in São Paulo, Brazil.METHODS:
From December 2019 to February 2020, we collected patient data regarding demographics, kidney function parameters and comorbidities. We then analyzed data on 394 patients who met a nephrologist for their first appointment.RESULTS:
The main comorbidities were hypertension (63.7%), diabetes (33.5%) and nephrolithiasis (22.3%). Regarding CKD stages, 24.1%, 9.1%, 13.7%, 15.2%, 15.2% and 2.3% of the patients were in stages 1, 2, 3a, 3b, 4 and 5, respectively. Proteinuria was absent or mild, moderate and high in 17.3%, 15.2% and 11.7%, respectively; and 16.2% had not undergone previous investigation of serum creatinine or proteinuria (55.8%). For 17.5%, referral to a nephrologist occurred late. Patients in public services were older than those in private services (59 years versus 51 years, respectively; P = 0.001), more frequently hypertensive (69.7% versus 57.5%; P = 0.01) and reached a nephrologist later (22.4% versus 12.4%; P = 0.009).CONCLUSION:
Referrals to a nephrologist were not being made using any guidelines for CKD risk and many cases could have been managed within primary care. Late referral to a nephrologist happened in one-fifth of the cases and more frequently in the public service.Key words
Full text:
1
Index:
LILACS
Main subject:
Renal Insufficiency, Chronic
/
Hypertension
/
Nephrology
Type of study:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
MEDICINA
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2022
Type:
Article