The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000300366 |
Resumo: | ABSTRACT BACKGROUND: The number of nephrologists has risen slowly, compared with the prevalence of chronic kidney disease (CKD) in Brazil. Data on patients referred to nephrology outpatient clinics remains scarce. OBJECTIVE: To determine the demographic and kidney function characteristics of patients at their first appointment with a nephrologist. DESIGN AND SETTING: Retrospective study conducted at three nephrology outpatient clinics (public and private services), in São Paulo, Brazil. METHODS: From December 2019 to February 2020, we collected patient data regarding demographics, kidney function parameters and comorbidities. We then analyzed data on 394 patients who met a nephrologist for their first appointment. RESULTS: The main comorbidities were hypertension (63.7%), diabetes (33.5%) and nephrolithiasis (22.3%). Regarding CKD stages, 24.1%, 9.1%, 13.7%, 15.2%, 15.2% and 2.3% of the patients were in stages 1, 2, 3a, 3b, 4 and 5, respectively. Proteinuria was absent or mild, moderate and high in 17.3%, 15.2% and 11.7%, respectively; and 16.2% had not undergone previous investigation of serum creatinine or proteinuria (55.8%). For 17.5%, referral to a nephrologist occurred late. Patients in public services were older than those in private services (59 years versus 51 years, respectively; P = 0.001), more frequently hypertensive (69.7% versus 57.5%; P = 0.01) and reached a nephrologist later (22.4% versus 12.4%; P = 0.009). CONCLUSION: Referrals to a nephrologist were not being made using any guidelines for CKD risk and many cases could have been managed within primary care. Late referral to a nephrologist happened in one-fifth of the cases and more frequently in the public service. |
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The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective studyNephrologyPrimary health careRenal insufficiency, chronicReferralAppointmentPrimary health careChronic kidney diseaseABSTRACT BACKGROUND: The number of nephrologists has risen slowly, compared with the prevalence of chronic kidney disease (CKD) in Brazil. Data on patients referred to nephrology outpatient clinics remains scarce. OBJECTIVE: To determine the demographic and kidney function characteristics of patients at their first appointment with a nephrologist. DESIGN AND SETTING: Retrospective study conducted at three nephrology outpatient clinics (public and private services), in São Paulo, Brazil. METHODS: From December 2019 to February 2020, we collected patient data regarding demographics, kidney function parameters and comorbidities. We then analyzed data on 394 patients who met a nephrologist for their first appointment. RESULTS: The main comorbidities were hypertension (63.7%), diabetes (33.5%) and nephrolithiasis (22.3%). Regarding CKD stages, 24.1%, 9.1%, 13.7%, 15.2%, 15.2% and 2.3% of the patients were in stages 1, 2, 3a, 3b, 4 and 5, respectively. Proteinuria was absent or mild, moderate and high in 17.3%, 15.2% and 11.7%, respectively; and 16.2% had not undergone previous investigation of serum creatinine or proteinuria (55.8%). For 17.5%, referral to a nephrologist occurred late. Patients in public services were older than those in private services (59 years versus 51 years, respectively; P = 0.001), more frequently hypertensive (69.7% versus 57.5%; P = 0.01) and reached a nephrologist later (22.4% versus 12.4%; P = 0.009). CONCLUSION: Referrals to a nephrologist were not being made using any guidelines for CKD risk and many cases could have been managed within primary care. Late referral to a nephrologist happened in one-fifth of the cases and more frequently in the public service.Associação Paulista de Medicina - APM2022-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000300366Sao Paulo Medical Journal v.140 n.3 2022reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2021.0194.r1.13082021info:eu-repo/semantics/openAccessSamaan,FaridFernandes,Danilo EuclidesKirsztajn,Gianna MastroianniSesso,Ricardoeng2022-05-12T00:00:00Zoai:scielo:S1516-31802022000300366Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2022-05-12T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study |
title |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study |
spellingShingle |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study Samaan,Farid Nephrology Primary health care Renal insufficiency, chronic Referral Appointment Primary health care Chronic kidney disease |
title_short |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study |
title_full |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study |
title_fullStr |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study |
title_full_unstemmed |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study |
title_sort |
The first appointment with a nephrologist: Brazilian patients’ demographic and kidney function characteristics. A retrospective study |
author |
Samaan,Farid |
author_facet |
Samaan,Farid Fernandes,Danilo Euclides Kirsztajn,Gianna Mastroianni Sesso,Ricardo |
author_role |
author |
author2 |
Fernandes,Danilo Euclides Kirsztajn,Gianna Mastroianni Sesso,Ricardo |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Samaan,Farid Fernandes,Danilo Euclides Kirsztajn,Gianna Mastroianni Sesso,Ricardo |
dc.subject.por.fl_str_mv |
Nephrology Primary health care Renal insufficiency, chronic Referral Appointment Primary health care Chronic kidney disease |
topic |
Nephrology Primary health care Renal insufficiency, chronic Referral Appointment Primary health care Chronic kidney disease |
description |
ABSTRACT BACKGROUND: The number of nephrologists has risen slowly, compared with the prevalence of chronic kidney disease (CKD) in Brazil. Data on patients referred to nephrology outpatient clinics remains scarce. OBJECTIVE: To determine the demographic and kidney function characteristics of patients at their first appointment with a nephrologist. DESIGN AND SETTING: Retrospective study conducted at three nephrology outpatient clinics (public and private services), in São Paulo, Brazil. METHODS: From December 2019 to February 2020, we collected patient data regarding demographics, kidney function parameters and comorbidities. We then analyzed data on 394 patients who met a nephrologist for their first appointment. RESULTS: The main comorbidities were hypertension (63.7%), diabetes (33.5%) and nephrolithiasis (22.3%). Regarding CKD stages, 24.1%, 9.1%, 13.7%, 15.2%, 15.2% and 2.3% of the patients were in stages 1, 2, 3a, 3b, 4 and 5, respectively. Proteinuria was absent or mild, moderate and high in 17.3%, 15.2% and 11.7%, respectively; and 16.2% had not undergone previous investigation of serum creatinine or proteinuria (55.8%). For 17.5%, referral to a nephrologist occurred late. Patients in public services were older than those in private services (59 years versus 51 years, respectively; P = 0.001), more frequently hypertensive (69.7% versus 57.5%; P = 0.01) and reached a nephrologist later (22.4% versus 12.4%; P = 0.009). CONCLUSION: Referrals to a nephrologist were not being made using any guidelines for CKD risk and many cases could have been managed within primary care. Late referral to a nephrologist happened in one-fifth of the cases and more frequently in the public service. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000300366 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000300366 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2021.0194.r1.13082021 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.140 n.3 2022 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
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1754209268650737664 |