Early referral in chronic kidney disease―seizing the opportunity

Abstract

Background: Chronic kidney disease (CKD) is characterized by progressive loss of kidney function, which can eventually result in the need for renal replacement therapy (RRT) such as dialysis or transplantation. This study aimed to review the impact of early referral of CKD patients to nephrologist and its impact on disease progression, cost of treatment and disease outcome. Methods: The study was done based on scholarly articles from PubMed using the keywords. Results: Early referral of CKD patients is associated with slower disease progression, improved patient outcomes, and reduced cost of treatment. Late referral can result in unplanned dialysis, with its likely deleterious consequences Other than a few studies that have brought forth contrary results regarding some long-term patient outcomes, most of the literature supports the beneficial effects of timely referral. Robust referral protocols can decrease the referral of low-risk CKD patients, thus lessening the load on nephrology services. Conclusion: To optimize CKD patient referrals, clarity is needed regarding the definition of early referral and, most importantly, primary care physicians need to be made aware of the available tools for referral to nephrology care.