[Reasons for first-consultation in nephrology in the health area 5 of Britanny during the year 2014].
BACKGROUND
In France, the coordinated healthcare circuit means that patients should be referred to specialists, for example nephrologists, by another physician. However, there are no recommendations concerning the reasons justifying the referral to a nephrologist. The main purpose of our study is to describe the motif of first consultations in nephrology in the health area 5 of Brittany.


METHODS
We retrospectively collected medical reports of first consultations by 17 nephrologists in the 4 centers of the study area, during the year 2014. In these letters, we noted the consultation motif, the specialty of the physician who refers the patient, and main characteristics of patients.


RESULTS
We included 662 first consultations. The main reason for consultations was chronic kidney disease (68.7%), including chronic renal insufficiency (56.9%), proteinuria (7.3%), microscopic hematuria (3.3%) and searching for chronic kidney disease in the presence of risk factor (1.2%). Other frequent reasons were the follow-up consultation after a pregnancy complicated by preeclampsia (9.5%), urinary lithiasis (5.7%), hypertension (3.8%) and hydroelectrolytic disorder (3.5%). Non-nephrology reasons represent 3.2% of first consultations. Almost all patients have been referred by a physician (99.7%), mainly a general practitioner (71.9%).


CONCLUSIONS
Nephrology first consultations are realized according to the coordinated healthcare circuit since almost all are requested by another physician. The reasons are adapted to the specialty. The main reason is chronic kidney disease, often already associated with renal insufficiency chronic.
Service de néphrologie, faculté de médecine et de pharmacie de Rennes, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. Electronic address: jeanne.lou.prevot@gmail.com.
Jeanne
J
Prévot
EHESP, CS 74312, 15, avenue du Pr-Léon-Bernard, 35043 Rennes, France.
Sahar
S
Bayat-Makoei
Service de néphrologie, faculté de médecine et de pharmacie de Rennes, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
Cécile
C
Vigneau
D000328:Adult; D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D058005:General Practitioners; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009398:Nephrology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies
Gatekeeping; Insuffisance rénale chronique; Kidney diseases; Maladies du rein; Orientation vers un spécialiste; Referral and consultation; Renal chronic disease; Régulation de l’accès aux soins spécialisés