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Referring patients with chronic kidney disease back to primary care: A criteria-based analysis in outpatient renal clinics

BMC Nephrology May 25, 2021

van Dipten C, van Dam DGHA, de Grauw WJC, et al. - Given that a critical review of the need for secondary care facilities as well as the possibilities for referral back to primary care is required in view of the increased demand for nephrology care for patients with chronic kidney disease, researchers herein assessed the features as well as the numbers of patients who could potentially be referred back to primary care, applying predefined criteria created by nephrologists and general practitioners. Including eight nephrologists and two general practitioners, a consensus meeting was arranged to define the back referral (BR) criteria. The BR criteria was satisfied by 78 of the 300 patients (26%) in the outpatient clinics. Patients who fulfilled the BR criteria exhibited the following features: 56.4% male, a median age of 70, an average of 3.0 outpatients visits per year, and a mean estimated glomerular filtration rate of 46 ml/min/1,73m 2 . Findings revealed that eligibility for referral back to primary care was met by a substantial proportion of patients. Often, presence of a comorbidity, such as hypertension or diabetes, was seen in these patients.

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