Nephrol Dial Transplant (1992) 7: 467-471
© 1992 European Renal Association-European Dialysis and Transplant Association
research-article
Early deaths on renal replacement therapy: the need for early nephrological referral
Department of Renal Medicine, Nottingham City Hospital Nottingham, UK
Correspondence and offprint requests to: Correspondence and offprint requests to: Dr A. Innes, Department of Renal Medicine, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK.
Forty-four patients who commenced renal replacement therapy between January 1983 and January 1988 died within 1 year of starting treatment. To examine the factors influencing early mortality of patients on renal replacement therapy these patients (group A) were compared with a group of 44 ageand sex-matched subjects who started dialysis over the same period and who survived more than 1 year (group B). The interval between first presentation and dialysis was significantly shorter in group A (median 36 days) than group B (median 30 months) patients. Plasma urea and creatinine were significantly greater in group A than group B at the time of first presentation to a nephrologist but not at first dialysis. Patients in group A were more often treated first by haemodialysis. Systemic disease as the cause of renal failure did not appear to influence early death. Early death on renal replacement therapy appears to be associated with late referral to a nephrologist. Early referral may be beneficial because it allows for planning of dialysis and treatment of the complications of progressive uraemia.
Keywords: renal replacement therapy; RRT; nephrological referral; mortality
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