Epidemiological factors associated with early referral to a nephrologist to start chronic hemodialysis in patients at a Public Hospital in Peru

Objective: Our objective was to establish the frequency of early referral to the nephrologist for the initiation of hemodialysis (HD) and its associated epidemiological factors in patients with chronic kidney disease (CKD) in a public hospital in Peru. Material and methods: We conducted an analytical cross-sectional study in patients who started HD in a public hospital in Peru. Our main variable was early referral, defined as patients who received an indication of onset of HD after 180 days of the first appointment in the nephrology service. We collected epidemiological and laboratory variables. We used crude and adjusted generalized linear models (GLM) and we calculated the proportion ratio (PR) with a 95% confidence interval (CI) as a measure of association. Results: We evaluated 148 patients; we found early referral in 17% of the population. In the adjusted GLM, participants older than 60 years had a higher proportion of early referral to the nephrologist, PR = 2.17; 95% CI (1.09-4.32); p = 0.03. We showed a lower frequency of early referral among participants with severe anemia, PR = 0.15; 95% CI (0.02-1.11); p = 0.06. Conclusions: The frequency of early referral is low and it should be considered a public health problem. We recommend improving the process of referral in our health care network. How to cite this article: Huauya-Leuyacc C, Palacios-Guillen AM, Benites-Zapata VA. [Epidemiological factors associated with early referral to a nephrologist to start chronic hemodialysis in patients at a Public Hospital in Peru]. Rev Nefrol Dial Traspl. 2018; 38(2):126-33.