Chronic kidney disease (CKD) is increasing in prevalence world-wide with the largest growth being in the elderly. The aim of this study was to examine the prevalence of CKD in a geriatric outpatient clinic within a tertiary hospital and its association with anaemia and mortality with a focus on the referral patterns towards nephrologists.
Retrospective study utilising administrative databases. The cohort was defined as all patients that attended the geriatric outpatient clinics of a single tertiary hospital within the first 3months of 2006. Patients were followed for 18months for mortality and referral to a nephrologist.
The mean Glomerular filtration rate (eGFR) of the 439 patients was 67.4±29.1mL/min/1.73m2 (44% <60mL/min/1.73m2). 11.8% had a haemoglobin<110g/L, with anaemia being significantly associated with kidney function in those with a eGFR<60mL/min/1.73m2 (p=0.0092). Kidney function and anaemia were significantly associated with mortality on multivariate analysis (p=0.019 and p=0.0074). After 18months, 8.8% of patients with CKD were referred to a nephrologist.
Despite a high prevalence of CKD in patients attending a geriatric outpatient clinic and its association with anaemia and mortality, few of these patients were referred to a nephrologist. An examination of the reasons behind this bias is required.
Keywords: Anaemia, Chronic kidney failure, Geriatrics, Referral and consultation