Improvement of clinical outcome by early nephrology referral in type II XXXX on hemodialysis.

@entity1 @entity1011 @entity6 @entity2033
OBJECTIVES: To evaluate the influence of early nephrology referral on clinical outcome in @entity6 @entity1 on maintenance hemodialysis dialysis. @entity1 AND METHODS: This study retrospectively analyzed the type II @entity6 @entity1 entering our PD program from February 1988 to June 2001. @entity1 who were presented to a nephrologist more than 6 months before starting dialysis were defined as early referral (ER). @entity1 were considered late referral (LR) if they were transferred to the nephrology department within 6 months before initial dialysis. RESULTS: Hundred and fifteen type II @entity6 @entity1 receiving @entity2033 for at least 3 months were enrolled in this study. Sixteen of the 53 @entity1 (46.1%) were in the ER group and 62 of the 115 (53.9%) were in the LR group. In univariate analysis by Cox proportional hazards mode, the early referral (Exp (Coef) = 0.423, p < 0.01), good glycemic control (Exp (Coef) = 0.16, p < 0.05), and age at dialysis (Exp (Coef) = 1.026, p < 0.05 (had significantly influenced the @entity1 survival. The residual renal function in the ER group, estimated by @entity1011 clearance (Ccr), significantly exceeded that of the LR group (ER vs. LR: 4.46 +/- 1.56 vs. 2.51 +/- 1.70 mL/min, p < 0.001). The @entity1 with early referral had significantly better survival (p < 0.05). Five-year survival improved significantly in the early referral group compared to the late referral group (ER: 72.4%; LR: 35.2%, p < 0.05). CONCLUSIONS: We demonstrate that the time of referral before starting dialysis is a predictor of survival for type II @entity6 on @entity2033 . @entity1 with early referral are associated with longer survival. The beneficial effect might be associated with the timely initiation of the chronic @entity2033 program. These results suggest that early referral before dialysis is important in determining the long-term prognosis in type II @entity6 on @entity2033 .
