Article - April 14, 2008 - Endocrine Today

Outpatient nephrologic care resulted in fewer deaths in patients with diabetes, CKD

By Katie Kalvaitis

Greater consistency of outpatient nephrologic care was associated with decreased mortality in patients with diabetes and stage-3 or stage-4 chronic kidney disease, according to new data.

However, these findings are troublesome, according to the researchers, because only a minority of patients received nephrologic care during the dialysis-free phase.

The researchers examined the frequency and consistency of outpatient nephrologic care in 39,031 patients. They calculated the number of visits to a nephrologist during a mean follow-up of 19.3 months. The majority of patients had early stage-3 chronic kidney disease (70%), followed by late stage-3 (22.4%) and stage-4 (7.6%).

More than one-quarter (28.2%) of patients with stage-4 chronic kidney disease visited a nephrologist. The numbers were lower for patients with early stage-3 (3.1%) and late stage-3 chronic kidney disease (9.5%).

Those patients with more visits to the nephrologist tended to have a lower mortality rate — 9.6 per 100 person-years for patients with early stage-3 chronic kidney disease; 14.1 per 100 person-years for patients with late stage-3 chronic kidney disease; and 19.4 per 100 person-years for patients with stage-4 chronic kidney disease.

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