Table 1.

Studies analysing referral for dialysis

Reference	Time period	Number	Definition of LR	% of LR patients	Mortality	PD//HD	Hospitalization	Special remarks
Cass [32] 2002, AUS/NZ	1 April 1995–31 December 1998	4234	3 months before RRT	26%	Hazard ratio 1.19/95% CI	NA	NA	Excluded unavoidable LR 3.5%; % of transplanted patients
Schwenger [26] 2006, Austria/Germany	1 January 1998–31 December 2001	280	17 weeks before RRT	39.6%	LR 34.2% versus ER 5.5% within 1 year	PD: 18.2% Austria, 10.2% Germany	LR 16 days (4–104), ER 11 days (4–32)	Two-centre study
Roderick [15] 2002, UK	1 June 1996–31 May 1997	361	4 months prior to RRT	35%	Death within 6 months	NA	10 days	Differentiation unavoidable/avoidable
			1 month prior to RRT	23%	16%		18 days
					32%
Winkelmayer [50] 2001, USA	January 1991–June 1996	3014	3 months prior to RRT	35%	NA	78% HD, 22% PD	NA	Determinants given for initial modality choice and switch
Nakamura [69] 2007, Japan	1983–2003	366	6 months prior to RRT	47%	Death within 1 year after start of RRT	NA	NA	Single centre
Wauters [70] 2004, France	November 1999–March 2001	279	6 months prior to RRT: ER	71.6%	NA	ER 13.5%, LR 13.9%	NA	Region wide, multi-centre study
			6–1 months: intermediate reference	15.1%
			Less than 1 month: LR	13.3%
Sesso [71] 1996, Brazil	October 1992–March 1995	184	1 month prior to RRT	57%	Survival rate: LR 69%, ER 87%; hazard ratio 2.77	LR 2.8%. ER 5.1%;	NA
						iPD LR 23.6%, ER 32.1%
Górriz [72] 2002, Spain	1996–97	362	6 months prior to RRT	37.3%	6-month survival rate: LR 10.2%, ER 3.2%; 3 years mortality: LR 36.9%, ER 24.9%	ER/planned 18.3% PD, uPL LR: 5.1%	ER 4.0 days (± 6.2 days), LR 17.7 (±14.6 days)	Multi-centre study, planned and unplanned referrals
Metcalfe [73] 2000, Scotland	October 1997–September 1998	533	Planned and unplanned referral	24.6% unplanned referral	Hazard ratio: unplanned 3.6 (1.4–9.3)	23% of 90 days survivors started on PD	Planned 3 days (0–94 days), unplanned 9 days (0–124 days)	Planned/unplanned, no recovery from ARF
Roubicek [43] 2000, France	January 1989–December 1996	270	4 months prior to RRT	31%	Not significant	NA	NA
Schmidt [74] 1998, USA	January 1990–April 1997	238	1 month prior to RRT	35%
Ifudu [75] 1999	1990–94	220	No nephrological care	57%
Sesso [40] 1996, Brazil	October 1992–March 1995	184	1 month prior to RRT	57%	Survival rate: LR 69%, ER 87%; hazard ratio 2.77	LR 2.8%. ER 5.1%;	NA
						iPD LR 23.6%, ER 32.1%
Korevaar [76] 2001, The Netherlands	January 1997–May 1999	253	1 month prior to RRT	37%	Hazard ratio 1.66
Astor [65] 2001, USA	October 1995–June 1996	356	1 month prior to RRT	25%
Lameire [77] 1997, Europe	January 1993–December 1995		1 month prior to RRT	35%
Van Biesen [78] 1998, Europe	January 1996–December 1997		1 month prior to RRT	29%	Deaths in the LRs 26.7 versus 16.4%	23% LR on PD, ER 49% on PD	Late versus early referrals (15.1 ± 16.0 versus 27.8 ± 23.7 days)
Khan [79] 1994, UK		304	Referred and non-referral to specialist		2-year survival rate: 58.7% referred, 25% non-referred patients
Navaneethan [80] 2007, USA	March 2003–March 2005	204	GFR <15 ml/min: LR (CKD V), CKD I- IV: ER	22%	1-year survival rate: LR 18%, ER 9%	NA	NA
Obialo [9], 2005, USA	1999–2002	460	3 months prior to RRT: LR, under 1 month: ultra LR	46% ultralate referred, 37% LR	Mortality 40% ULR versus 15% ER and 26% LR	NA	NA	Socioeconomic implications
Steel [81] 2002, USA	1996–2000	494	Referral 3 months prior to RRT					Sociodemographic factors for LR
Abderrahim [82] 2001, Tunesia	1990–96	299	NA	29–36%	NA	NA	NA	Subgroup analysis: diabetes leading to ESRD
Bhan [83] 2007, Canada	1 year	93	3 months prior to RRT	48%	NA	NA	NA	Analysis on vascular access
Curtis [84,85] 2005, Canada/Italy	1997–1998/1999–30 June 2002	288	3 months prior to RRT	NA	Standard nephrology clinic versus multi-disciplinary clinic attendance (hazards ratio 2.17)	ER patients 40% PD, 60% HD	NA	Includes only ER patients, analysis of multi-disciplinary clinic care
Frimat [86] 2004, France	1997–99	508 // 148 patients with diabetes type II	3 months prior to RRT	27%		75% HD, 25% PD	NA	Subgroup analysis: type II diabetes leading to ESRD
Kazmi WH [85] 2004, USA	1996–97	2195	4 months prior to RRT	33%	Hazard ratio 1.44 from LR death within 1 year	53% ER 40% LR	NA	WAVE II study
Lorenzo [87] 2004, USA	1998–2003	538	3 months prior to RRT: planned presentation	281 planned patients (52%), 257 unplanned patients (48%)	Unplanned presentation hazard ratio (HR), 1.73	NA	All-cause hospitalization (incidence rate ratio, 1.56; 95% CI, 1.36 to 1.79; P < 0.001)	Differentiation planned/ unplanned
Riegel [88] 2005, Germany	July 2002–March 2003	551	CKD IV: ER	58% referred late: CKD V	NA	NA	11.4 days ER, 17.4 days LR
Ellis [89] 1998, UK	1996–97	198	3 months prior to RRT	32% LR	12-month survival 60.5% versus 72.5%	NA	25 days LR versus 9.7 days ER
Avorn [36] 2002, USA	1991–96	3014	3 months prior to RRT	34.5%	37% increase in risk of death in the first year of dialysis	NA	NA
Castellano [90] 2006, Spain	2003–04	117	Planned and unplanned	44% unplanned, 56% planned	6-month mortality 4.6% versus 11.5%	NA	23.6 days unplanned, 3 days
Gallego [91] 2003, Spain	1994–98	139	6 months prior to RRT	23%	Mean survival time: 73.6 ± 4.3 months (ER) and 73.0 ± 6 months (LR)	NA	NA
GIMEP [92] 2002, Italy	1998–99	1137	2 months prior to RRT	45%	NA	44% ER, 9.1% LR	NA	Multi-centre study
Gøransson [93] 2001, Norway	1984–98	242	3 months prior to RRT	27%	NA	NA	31 days LR, 7 days ER
Lhotta [94] 2003, Austria	January 1999– October 2000	75	GFR dependent: referral when GFR <20 ml: LR	56%	2-year follow-up: 45% deaths LR, 24% ER	NA	NA
Lin [95] 2003, Taiwan	February 1988–June 2001	115	6 months prior to RRT	53%	5-year follow-up: ER: 72.4%; LR: 35.2%	NA	NA	Subgroup analysis of type II diabetes
Pena [96] 2006, Spain	January 1990 to December 2001	178	4 months prior to RRT	22%		NA	NA