title: Referral to the nephrology outpatient clinic: inappropriate referral to the nephrologist.
abstract: BACKGROUND
  There are scarce data in Brazil concerning the referral of the patients with renal diseases to the nephrologist care.
  
  
  OBJECTIVE
  The aim of the present study was to describe the adequacy of early referral of these patients to a nephrology out-patient clinic.
  
  
  METHODS
  It was a cross-sectional study. Data of the first visit of the patient to the nephrologists were collected. The decision of the nephrologist, regarding the admittance of the patient to the followup with the nephrology team was also described.
  
  
  RESULTS
  We evaluated 150 patients, with mean age of 49 ± 16 years, and 56% of females. The need of a consultation and follow-up with the renal specialist was found in only 71 patients (47.3%) and all these patients were enrolled in the nephrology unit out-patient clinic for, at least, one visit a year. All the patients with chronic kidney disease stages 3 to 5 were recommended to maintaining visits to the nephrologist, whereas 60% of those with diabetes and/or hypertension and 50% of those with renal lythiasis were also enrolled in the same program. Approximately 50% of patients originated from public health system units and 70% of private doctors were adequately referred.
  
  
  CONCLUSIONS
  There was inadequate use of the abilities of the nefrologist as a specialist in the care of the patient with early stages of renal diseases. Other studies are needed to evaluate the efficiency of referral systems to the nephrologists in other areas of Brazil, with the purpose to rationalize supply and demand in the nephrology care.
authors.affiliation: Nephrology Service of Hospital Ana Neri – Universidade Federal da Bahia, Escola Bahiana de Medicina e Saúde Pública. bahiensem@ig.com.br
authors.forename: Marilia
authors.initials: M
authors.lastname: Bahiense-Oliveira
authors.forename: Daniella
authors.initials: D
authors.lastname: Duarte
authors.forename: Gabriela Góes Castro
authors.initials: GG
authors.lastname: Meira
authors.forename: João Jorge
authors.initials: JJ
authors.lastname: de Codes
authors.forename: Maria Zenaide
authors.initials: MZ
authors.lastname: Ribeiro
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009398:Nephrology; D012017:Referral and Consultation / Q000592:standards* / Q000706:statistics & numerical data