When should a CKD patient be referred to a nephrologist?
Early referral to a nephrologist is associated with improved outcomes once patients initiate dialysis.
Referral to a nephrologist is recommended when eGFR <30 mL/min per 1.73m 2 and/or urine albumin creatinine ratio is >300 mg/g, with earlier referral recommended in specific cases.
Early referral has been associated with several beneficial effects, including decreased mortality, reduced hospitalization, and improvement in the appropriate use of fistulas and grafts as opposed to catheters at the initiation of hemodialysis.
