Impact of nephrologic care in the early management of chronic kidney disease.

摘要

The recent article by Winkelmayer that appeared in the Archives in the August 8/22 issue brings forth questions that practicing nephrolo-gists have worried about for decades. However it should be titled "How late referral fails to change early renal replacement therapy outcomes." Outcomes for end-stage renal disease have not changed for the last 2 decades. Given the design of the study, which looked at fairly late referrals, the only parameters that showed improvement were anemia and vascular access placement.