Early referral as an independent predictor of clinical outcome in end-stage renal disease on hemodialysis and continuous ambulatory peritoneal dialysis

Abstract

Objectives. To evaluate the influence of early nephrology referral on clinical outcome in patients on maintenance hemodialysis (HD) and peritoneal dialysis (PD). Patients and Methods. This study retrospectively analyzed patients entering our HD and PD program from February 2000 to June 2003. Patients who presented to a nephrologist more than 6 months before starting dialysis were defined as early referral (ER). Meanwhile, patients transferred to the nephrology department less than 6 months before initial dialysis were considered late referral (LR). Results. HD Groups. Of 78 HD patients, 37 (47.1%) qualified for the ER group and 41 (52.6%) were designated to the LR group. The demographic data were analyzed for both the HD and PD groups. No significant differences in average age at dialysis, duration of hemodialysis, and gender were noted between these two groups. The same applied for the biochemical parameters in both groups. HD patients with early referral had significantly better survival (p