Late Referral to the Nephrologist in Outpatients Consultations

Abstract

Introduction: Chronic Kidney Disease presents a global prevalence of 10-15% on the rise. Referral to the nephrologist in the late stages is a problem for patients with this pathology. Objective: to verify in which stages of Chronic Kidney Disease the patients arrived at the consultation.

Methodology: Three hundred medical records of patients who consulted in the Renal Health Program of the National Institute of Nephrology were analyzed. For the statistical analyses, Excel Software, Student‘s T, Standard Deviation, and Percentages were used.

Results: The average age was 54.12 ± 16.45. 180 (60%) patients were female and 120 (40%) were male. The most frequent reason for consultation was control 199 (66.3%), the most frequent etiology 170 (56.6%) was diabetes mellitus, the average creatinine was 1.5 mg/dl (± 1.3), the proteinuria found was 846.6 ± 1627.3; creatinine clearance was 74.6 ± 46.5; the average stage in the consultation was 2.1 ± 1.3. Separating the population by sex, it was found that there was a difference in men‘s creatinine 1.9mg/dl± 1.6 vs 1.2mg/dl ± 0.9 women (P<0.0001); in the clearance men 64.99 ± 38.51ml/min vs women 80.17 ± 50.2 ml/min(P<0.005). The stage in men 2.3 ± 1.4 vs 1.9 ± 1.3 women (P< 0.001).

Conclusion: The main reason for which the patients consulted was for control, the most common etiology was Diabetes Mellitus. Regarding the stage in which the patients consulted, it was found that the majority were in the initial stage of kidney disease. In the division made by sex, men consulted at a later stage, had worse clearance and more proteinuria. These results are encouraging, they show that patients are referred to the nephrologist in the early stages of kidney disease, which will allow better follow-up, thereby reducing the morbidity and mortality of patients, on the other hand, more emphasis should be placed on education and awareness of the male population, regarding this disease.