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Logo of bmcgeriBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Geriatrics
 
BMC Geriatr. 2012; 12: 43.
Published online 2012 August 3. doi:  10.1186/1471-2318-12-43
PMCID: PMC3441322
Copyright ©2012 Boudville et al.; licensee BioMed Central Ltd.
Limited referral to nephrologists from a tertiary geriatric outpatient clinic despite a high prevalence of chronic kidney disease and anaemia
Neil Boudville,corresponding author1,2 Kalindu Muthucumarana,2 and Charles Inderjeeth1,3
1School of Medicine and Pharmacology, University of Western Australia, Verdun Street, Nedlands, WA, Australia
2Department of Renal Medicine, Sir Charles Gairdner Hospital, Verdun Street, Nedlands, WA, Australia
3Department of Aged Care and Rehabilitation, Sir Charles Gairdner Hospital, Verdun Street, Nedlands, Western Australia
corresponding authorCorresponding author.
Neil Boudville: neil.boudville/at/uwa.edu.au; Kalindu Muthucumarana: Kalindu.muthucumarana/at/health.wa.gov.au; Charles Inderjeeth: charles.inderjeeth/at/health.wa.gov.au
Received December 2, 2011; Accepted July 24, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
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.
Methods
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 3 months of 2006. Patients were followed for 18 months for mortality and referral to a nephrologist.
Results
The mean Glomerular filtration rate (eGFR) of the 439 patients was 67.4 ± 29.1 mL/min/1.73 m2 (44% <60 mL/min/1.73 m2). 11.8% had a haemoglobin < 110 g/L, with anaemia being significantly associated with kidney function in those with a eGFR < 60 mL/min/1.73 m2 (p = 0.0092). Kidney function and anaemia were significantly associated with mortality on multivariate analysis (p = 0.019 and p = 0.0074). After 18 months, 8.8% of patients with CKD were referred to a nephrologist.
Conclusion
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
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