Early Referral to a Nephrologist Improved Patient Survival: Prospective Cohort Study for End-Stage Renal Disease in Korea

摘要: The timing of referral to a nephrologist may influence the outcome chronic kidney disease patients, but its impact has not been evaluated thoroughly. results recent study showing an association between early and patient survival are still being debated. A total 1028 patients newly diagnosed as end-stage renal (ESRD) from July 2008 October 2011 were enrolled. Early (ER) was defined meeting with more than year before dialysis education provided, all others considered late (LR). relationship pattern mortality in ESRD explored using Cox proportional hazards regression models. Time significantly longer 599 ER 429 LR (62.3±58.9 versus 2.9±3.4 months, P<0.001). Emergency HD temporary vascular catheter required 485 (47.2%) out 262 (43.7%) compared 223 (52.0%) (P = 0.009). After 2 years follow-up, rate better that (hazard ratio [HR] 2.38, 95% confidence interval [CI] 1.27–4.45, P 0.007). In diabetes nephropathy, also higher (HR 4.74, CI 1.73–13.00, 0.002). With increasing age, HR increased. Timely predialytic stage is associated reduced mortality.