The aim of the study is to investigate the baseline epidemiological and clinical profiles of patients at first referral to a nephrology clinic.
Cross-sectional study of all outpatients newly referred to a nephrology clinic over 12 months.A total of 566 patients was examined (63.8 % males); mean age 62.8±18 years (13-95 years, modal value 72).
Serum creatinine and urinalysis had been determined prior to referral in 523/566 and 359/566 patients, respectively.
Sixty-nine percent of patients were referred by a primary care physician, 21 % by an internist and 10% for nephrologic follow-up after hospitalization. Referral indications included renal impairment (65 %), urinary abnormalities (41 %), and morphological alterations (14 %).
Seventy-one % of patients had hypertension, 40.3% heart disease, 23.3% arterial-vascular disease, 27% diabetes, 26% urologic disease and 18% malignancies (mean number of comorbidities 3.0±2.0).
Serum creatinine ranged 0.43-7.75 mg/dl, mean 1.6±0.8, and the eGFR (MDRD simplified formula) ranged 6.9-159, mean 53±27 ml/min/1.73m²; CKD stage 1: 9%; stage 2: 22%; stage 3a: 24%, stage 3b 27% and CKD stages 4&5: 19%. Fourty-five % of patients, classified as CKD stage 2 or 3a(GFR <90->45 ml/min/1.73 m2), had a normal renal function after adjustement of eGFR to their age, assuming a reduction of 1 ml/min/1.73 m2 per year over the age of 40 years.
Abdominal ultrasounds had been performed on 346/566 patients.Renal dimensions were measured only in 25.8 %.
Fifty-one % had abnormalities of echogenicity, 21.2 % cysts, 6.5 % stones, 3.1 % focal space-occupying lesions and 3.8 % urinary tract dilation.
The majority of patients are referred to a nephrology clinic by their doctor, due to impaired eGFR, often without urinalysis.They are elderly patients, with a high incidence of arterial hypertension and cardiovascular and metabolic comorbidities.Possibly, many aged patients are misclassified for CKD stage, if eGFR is not adjusted to age.
