Document Detail

Criteria for referring patients with renal disease for nephrology consultation: a review of the literature.
MedLine Citation:
PMID:  20540033     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Referrals to nephrologists comprise not only patients with chronic kidney disease but also those with other nephrological conditions. There may be confusion about when to refer a patient to a nephrologist. We conducted a literature review to identify preexisting priority-setting, triage or referral criteria developed to guide referrals from primary care to a nephrologist. METHODS: Medline and Cochrane databases were searched (1997 to 2008) using search terms: referral, consultation, triage and a list of specified nephrological conditions. Abstracts were assessed by 2 reviewers using criteria to determine relevance. Citation and hand searches were done on papers selected for review; relevant Web sites were also consulted. Two reviewers read all selected papers to determine if they met the objectives. One reviewer abstracted relevant data from each retained reference and compiled the results into a report, which was reviewed by 3 practicing nephrologists. RESULTS: There were 18 retained papers, reports or Web sites; 4 of these were professional national guidelines. All but 1 reference cited serum creatinine or estimated glomerular filtration rate as a criterion for referral. Other referral criteria were proteinuria (8 sources), blood pressure (5 sources), electrolytes (3 sources) or hematuria (3 sources). There was inconsistency in referral recommendations. CONCLUSIONS: The differing advice identified in the literature results in confusion as to when patients should be referred to a nephrologist. Nephrologists, an already strained human resource, must prioritize requests for consultation using an undefined and no doubt inconsistent metric. Standardized, diagnosis-neutral criteria would benefit both primary care providers and nephrologists.
Carolyn De Coster; Kevin McLaughlin; Tom W Noseworthy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of nephrology     Volume:  23     ISSN:  1121-8428     ISO Abbreviation:  J. Nephrol.     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  399-407     Citation Subset:  IM    
Strategy and Performance, Alberta Health Services, Alberta, Canada.
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MeSH Terms
Glomerular Filtration Rate
Kidney Diseases / therapy*
Referral and Consultation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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