Background
Methods
Search Strategy
Characteristics of Included Studies
Study | Year | Type of study | Setting/Country/Number of participants | Definition of Late referral (months prior to start of dialysis or stage of CKD) | Patient related factor | Health care related factor |
---|---|---|---|---|---|---|
Arora [23] | 1999 | Retrospective | Tertiary referral center/USA/135 dialysis patients | <4 months | ● | |
Cass [22] | 2003 | Retrospective | Australian and New Zealand dialysis and transplantation registry/3334 patients | <3 months | ● | |
Ifudu [28] | 1999 | Retrospective | Tertiary referral center/USA/220 dialysis patients | Creatinine > 4 mg/dl | ● | |
Jungers [16] | 1993 | Retrospective | Single dialysis center/France/354 patients | <1 month | ● | |
Khan [21] | 1994 | Retrospective | Renal infirmary/UK/304 CKD patients | NA | ● | |
Kinchen [15] | 2002 | Prospective cohort | Dialysis centers/USA/828 dialysis patients | <4 months | ● | ● |
Navaneethan (30) | 2007 | Retrospective | 2 Dialysis units/USA/205 patients | <6 months | ● | ● |
Obialo [29] | 2005 | Retrospective | Tertiary referral center/USA/460 patients | <3 months-Late referral <1 month-ultra late referral | ● | |
Roderick [25] | 2002 | Retrospective | Tertiary referral center/UK/250 dialysis patients | < 4 months | ● | |
Schmidt [17] | 1998 | Retrospective | 3 Dialysis units/USA/238 patients | <1 month | ● | |
Steel [27] | 2002 | Retrospective | Single dialysis center/UK/494 dialysis patients | < 3 months | ● | |
Winkelmayer [26] | 2001 | Retrospective | New Jersey ESRD data/USA/3014 dialysis patients | < 3 months | ● | ● |
Wauters [18] | 2004 | Prospective cohort | Multiple dialysis centers/Europe/279 dialysis patients | <6 months | ● | ● |
Study | Year | Type of study | Country/No. of physicians | Types of physicians | Referral predictors identified |
---|---|---|---|---|---|
Boulware [34] | 2006 | Physician Survey | USA/304 | Family practioners/Internists/Nephrologists | Insurance status, non-compliance |
Campbell [33] | 1989 | Physician interview | UK/86 | General physicians | Lack of specific referral criteria, Patient refusal, Physician rationing |
Lameire [24] | 1999 | Survey of dialysis units | Europe/NA | General physicians/Internists/Specialists | Physician rationing based on age, presence of comorbidities |
Mendelssohn [32] | 1995 | Physician survey | Canada/728 | Family practioners/Internists | Increasing age, presence of comorbidities, shorter life expectancy |
Parry [31] | 1994 | Physician survey | UK/203 | Geriatricians/General physicians/Nephrologists | Increasing age, presence of comorbidities, availability of dialysis centers |
Results
Patient Characteristics
Age and Gender
Race
Comorbidity
Etiology of Renal disease
Patient Non-compliance
Health system related
Insurance status
Type and location of referral and dialysis center
Physician factors
Discussion
Key Findings
Patient related factors | Health system related factors |
---|---|
Age | Insurance status |
Race | Type of referring physician |
Gender | Type of referring center |
Comorbid illness | Physician rationing |
Etiology of renal disease | Distance to dialysis center |
Patient noncompliance | |
Socioeconomic status |