{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T03:16:40Z","timestamp":1790047000423,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,11,25]],"date-time":"2011-11-25T00:00:00Z","timestamp":1322179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:p><jats:bold>Aims:\u2003<\/jats:bold> This study aims to characterise the timing of referral to a paediatric nephrology unit of children who develop end\u2010stage kidney disease (ESKD). This study also aims to determine whether late referral (LR) influences outcomes and to explore factors that may lead to LR.<\/jats:p><jats:p><jats:bold>Methods:\u2003<\/jats:bold> A retrospective case review of all incident patients with ESKD who received renal replacement therapy (RRT) at a single paediatric centre. Time between referral to a paediatric nephrologist and commencement of RRT, demographic and clinical data were collated. Estimated glomerular filtration rate (eGFR) at referral was calculated using height and creatinine. LR was defined as having an eGFR \u226430\u2003mL\/min\/1.73\u2003m<jats:sup>2<\/jats:sup> when first seen by a paediatric nephrologist.<\/jats:p><jats:p><jats:bold>Results:\u2003<\/jats:bold> RRT was initiated for 74 patients &lt;18\u2003years of age between 1988 and 2010. The median age at referral was 2.0\u2003years (birth\u201315.9\u2003years) and age at RRT was 10.0\u2003years (6\u2003days\u201317.4\u2003years). Children referred before age 1\u2003year (41%) had a more prolonged course before ESKD. Median (interquartile range) eGFR at referral of children &gt;1\u2003year was 27.2 (9.0\u201352.0) mL\/min\/1.73\u2003m<jats:sup>2<\/jats:sup>. Twenty\u2010two (55%) of these children were referred late (LR) with an eGFR \u226430\u2003mL\/min\/1.73\u2003m<jats:sup>2<\/jats:sup>. LR patients were more likely to have glomerulonephritis or haemolytic uraemic syndrome and to live in a remote or outer regional area. LR patients had higher urea, lower haemoglobin and were more likely to receive haemodialysis via a vascular catheter.<\/jats:p><jats:p><jats:bold>Conclusions:\u2003<\/jats:bold> A significant proportion of children who develop ESKD are referred late to nephrology units with potentially preventable complications. Aetiology of renal disease and geographic isolation contribute to LR.<\/jats:p>","DOI":"10.1111\/j.1440-1754.2011.02254.x","type":"journal-article","created":{"date-parts":[[2011,11,25]],"date-time":"2011-11-25T08:46:24Z","timestamp":1322210784000},"page":"253-258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Causes and outcome of late referral of children who develop end\u2010stage kidney disease"],"prefix":"10.1111","volume":"48","author":[{"given":"Sean E","family":"Kennedy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gad","family":"Kainer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,11,25]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-009-1181-2"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.08.024"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrdd.20116"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsm036"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200x.2004.01955.x"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902066"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00860930"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05791108"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.ndt.a027123"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.6.1416"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq215"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2010.01224.x"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2006.00716.x"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfi313"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-005-0458-0"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(03)00805-9"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfk030"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2002.tb04698.x"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V1061281"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh409"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/16.12.2357"},{"issue":"2","key":"e_1_2_8_23_2","doi-asserted-by":"crossref","first-page":"S273","DOI":"10.1177\/089686089901902S45","article-title":"The referral pattern of end\u2010stage renal disease patients and the initiation of dialysis: a European perspective","volume":"19","author":"Van Biesen W","year":"1999","journal-title":"Perit. Dial. Int."},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajkd.2003.07.006"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.04.024"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.174581"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-9-3"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1353-8292(02)00037-0"},{"key":"e_1_2_8_29_2","unstructured":"Australian Bureau of Statistics.Australian Standard Geographical Classification.2009; Catalogue No. 1216.0."},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.51.11.875"},{"key":"e_1_2_8_31_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0085"},{"key":"e_1_2_8_32_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2009.09.021"},{"key":"e_1_2_8_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00866349"},{"key":"e_1_2_8_34_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.107.6.1381"},{"key":"e_1_2_8_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-006-0381-2"},{"key":"e_1_2_8_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(02)00415-8"},{"key":"e_1_2_8_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000131524.52012.F8"},{"key":"e_1_2_8_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-008-0956-1"},{"key":"e_1_2_8_39_2","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2010.517347"},{"key":"e_1_2_8_40_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.4.e382"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1440-1754.2011.02254.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1440-1754.2011.02254.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T23:28:01Z","timestamp":1697326081000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1440-1754.2011.02254.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,11,25]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,3]]}},"alternative-id":["10.1111\/j.1440-1754.2011.02254.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1440-1754.2011.02254.x","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,11,25]]},"assertion":[{"value":"2011-11-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}