Late medical consultation for chronic renal failure
High risk for patients and high cost for health centers
Abstract
Patients lately hospitalized for chronic dialysis (CD) are at high risk, especially those who are in urgent need for dialysis treatment. Since 1981, over 50% of the patients under CRF treatment in Uruguay, had started it without any preparation. The aim of this study is to search the number of patients who did late consultation, morbimortality rates (MM), and associated costs to this condition during 2003 in Uruguay. Patients with end-stage renal disease (ESRD) were prospectively included in the study: 81 patients were identified. Fifty six patients (69.1%) showed a significative delay in seeking consultation, needed 1 120 days of hospitalization (20 days/patient) and 578 hemodialysis sessions (HD) in specialized centers (10.3 DH/patient). Five patients had died before starting CD and 9 died during the six first months after starting CD. Twenty five patients (30.9%) received planned dialysis, spent 73 days at hospital (2.9 days/patient) and no deaths were recorded. Hospitalization cost were 4800$ per patient in the cases of late consultation compared to 140$ for the planned patients. In conclusion: during 2003, most of the patients of the study population with ESRD required urgent HD at the beginning of the treatment. Hospitalization lenght, MM, and treatment cost were higher in patients with late consultation compared to planned-treatment patients.
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