[Early or late referral patterns of 1137 patients starting dialysis in 15 Italian dialysis centres]

Data on referral patterns of patients with end-stage renal failure starting renal replacement therapy were collected. The participating centres used the PFA Patients Flow Analysis (R) software programme, a Baxter tool designed to help improve data collection on dialysis patients from their first visit to the centre to the start of renal replacement therapy.

Data were collected on 1137 patients from 15 dialysis centres, mainly in northern Italy, with the aim of describing a) their referral modalities; b) their eligibility to renal replacement treatments; c) the number of early and late referrals utilising a permanent PD (Peritoneal Dialysis) or HD (Haemodialysis) access at the first treatment.

Early Referrals (ERs) (54%) are comparable in terms of their main characteristics (sex and age) to Late Referrals (LRs) but they have wider access to a PD or to the opportunity of choosing their dialysis modality. The majority (89%) of all ERs, have a permanent access at the first dialysis treatment and a larger number (44%) have a PD as permanent dialysis treatment. Centres with structured pre-dialysis educational programmes achieve better outcomes: 66.3% patients vs. 48.2% without enhanced education start the dialysis treatment with a permanent access and more patients (40% vs. 22%) receive a permanent PD.

Comparing centres with and without timely structured educational interventions seems to confirm the effectiveness of such education on the outcomes of ESRF patients.