Evidence mapPaperPMID 35751012Full record

ArticleBMC nephrology2022

Referral criteria for chronic kidney disease: implications for disease management and healthcare expenditure-analysis of a population-based sample.

Simone Kiel, Gesine Weckmann, Jean-François Chenot, Sylvia Stracke, Jacob Spallek, Aniela Angelow

Abstract read
In one paragraph

Article in BMC nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Framework of Guidelines for Management of CKD in Asia.Kidney international reports · 2024
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Simone Kiel *Department of General Practice, Institute for Community Medicine, University Medicine Greifswald, Fleischmannstrasse 6, Greifswald, 17475, Germany. simone.kiel@uni-greifswald.de.ORCID 0000-0001-8824-1244
Gesine Weckmann *Faculty of Applied Health Sciences, European University of Applied Sciences, Rostock, Germany.ORCID 0000-0003-2117-2154
Jean-François ChenotDepartment of General Practice, Institute for Community Medicine, University Medicine Greifswald, Fleischmannstrasse 6, Greifswald, 17475, Germany.ORCID 0000-0001-8877-2950
Sylvia StrackeDepartment of Internal Medicine A, Nephrology, University Medicine Greifswald, Greifswald, Germany.ORCID 0000-0001-6200-4339
Jacob SpallekDepartment of Public Health, Brandenburg University of Technology Cottbus- Senftenberg, Senftenberg, Germany.ORCID 0000-0001-6312-034X
Aniela AngelowDepartment of General Practice, Institute for Community Medicine, University Medicine Greifswald, Fleischmannstrasse 6, Greifswald, 17475, Germany.ORCID 0000-0003-1027-231X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical practice guidelines recommend specialist referral according to different criteria. The aim was to assess recommended and observed referral rate and health care expenditure according to recommendations from: • Kidney Disease Improving Global Outcomes (KDIGO,2012) • National Institute for Health and Care Excellence (NICE,2014) • German Society of Nephrology/German Society of Internal Medicine (DGfN/DGIM,2015) • German College of General Practitioners and Family Physicians (DEGAM,2019) • Kidney failure risk equation (NICE,2021)

methodsData of the population-based cohort Study of Health in Pomerania were matched with claims data. Proportion of subjects meeting referral criteria and corresponding health care expenditures were calculated and projected to the population of Mecklenburg-Vorpommern.

resultsData from 1927 subjects were analysed. Overall proportion of subjects meeting referral criteria ranged from 4.9% (DEGAM) to 8.3% (DGfN/DGIM). The majority of patients eligible for referral were ≥ 60 years. In subjects older than 60 years, differences were even more pronounced, and rates ranged from 9.7% (DEGAM) to 16.5% (DGfN/DGIM). Estimated population level costs varied between €1,432,440 (DEGAM) and €2,386,186 (DGfN/DGIM). From 190 patients with eGFR < 60 ml/min, 15 had a risk of end stage renal disease > 5% within the next 5 years.

conclusionsApplying different referral criteria results in different referral rates and costs. Referral rates exceed actually observed consultation rates. Criteria need to be evaluated in terms of available workforce, resources and regarding over- and underutilization of nephrology services.

Indexed as

NephrologyRenal Insufficiency, ChronicCohort StudiesDisease ManagementHealth ExpendituresHumansReferral and ConsultationChronic kidney diseaseGuideline recommendationsHealth care costsNephrology referralReferral

Identifiers

PMID35751012
PMCPMC9229756

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.