U of T Nephrology


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TSpace Repository School of Graduate Studies – Theses Master
Title:
Prevalence, Predictors, and Outcomes Associated with Late Start of Chronic Kidney Disease Care Amongst Adults with End-stage Renal Disease
Author:
Singhal, Rajni
Advisor:
Hux, Janet
Department:
Health Policy, Management and Evaluation
Keywords:
end-stage renal disease; dialysis; chronic kidney disease care; late referral; nephrology care; mortality; predictors; survival
Issue Date:
20-Dec-2011
Abstract (summary):
Using Ontario health administrative data, we identified 12,143 adults with chronic kidney disease (CKD) who received outpatient nephrology care prior to start of renal replacement therapy (RRT) in order to study the effect of care-related factors in predicting late start of predialysis care (PDC, defined as first outpatient nephrology visit <6 months prior to RRT start) and to explore covariates which further quantify the PDC received. Lack of an usual provider of primary care (OR 0.76; 95%CI 0.66, 0.87) predicted late start of PDC. In addition to late start of PDC, number of nephrology visits (OR 0.97 per visit; 95% CI 0.96, 0.98), and having seen a nephrologist in only 1 or 2 of the 6 months prior to RRT start (OR 1.33; 95%CI 1.18, 1.51), were also independent predictors of one-year mortality, suggesting that other measures of PDC are needed to better characterize the care received.
URI:
http://hdl.handle.net/1807/31446
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http://hdl.handle.net/1807/31446
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ASHWORTH MEDICINE-Professional Medical Assisting, Doctor of Science,Legal Assistant Diploma BSc Criminal Justice
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