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논문분류	춘계학술대회 초록집
제목	Referral Time to Nephrology Care
저자	Sungjin Chung
출판정보	2024; 2024(1):
키워드
초록	Early diagnosis of chronic kidney disease (CKD) through screening and timely referral to nephrologists is essential for delaying disease progression and potentially reversing its course. Extensive literature, including clinical studies and expert opinions, underscores the benefits of early referral and the adverse outcomes associated with delayed referral of CKD patients to nephrology specialists. While referral criteria vary across guidelines, traditional indications such as severely decreased estimated glomerular filtration rate (eGFR) or significant albuminuria may not capture all patients who could benefit from specialist care. Recent recommendations, like those from the Korean Society of Nephrology (KSN) in 2023, advocate broader referral criteria, prompting concerns among some specialists about their role in CKD management. However, it is crucial to note that nephrologists should not exclusively manage all CKD patients. Collaborative efforts with nephrologists facilitate precise diagnosis, tailored therapies, disease progression delay, complication prevention, and kidney replacement therapy (KRT) planning. In addition to conventional criteria based on eGFR or albuminuria, the use of externally validated risk equations to estimate kidney failure risk is advocated by guidelines such as National Institute for Health and Care Excellence (NICE) and Kidney Disease: Improving Global Outcomes (KDIGO). These equations enhance patient counseling and referral strategies, although their accuracy in early CKD stages and cost-effectiveness require further investigation. Despite concerns about increased workload or medical costs, early nephrology intervention within a multidisciplinary framework holds promise for optimizing CKD patient outcomes. Thus, timely referral to nephrology care, guided by comprehensive risk assessment, remains pivotal for enhancing patient well-being, emphasizing collaboration over individual initiative.
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