RT Journal Article SR Electronic T1 Diabetes and renal disease: who does what? JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 460 OP 464 DO 10.7861/clinmedicine.13-5-460 VO 13 IS 5 A1 Ruth K Jones A1 David Hampton A1 Daniel J O’Sullivan A1 Aled O Phillips YR 2013 UL http://www.rcpjournals.org/content/13/5/460.abstract AB Care of patients with diabetes and chronic kidney disease (CKD) in the UK is divided between primary care, diabetologists and nephrology. In a retrospective analysis, we examined the distribution of care provision for patients with diabetes and CKD. Nephrology services see a minority of diabetic patients with CKD, but they see the majority of those with an estimated glomerular filtration rate (eGFR) of <30 ml/min. Of those followed in nephrology, 70% showed no evidence of progressive renal dysfunction. The nephrology cohort were significantly younger that those seen by primary care physicians or diabetologists. Half of the patients with diabetes and CKD seen in either the primary care and diabetology cohorts, with no nephrology input, had a rate of fall of eGFR of >5 ml/min/yr. This suggests that older age might deter referral to nephrology, which is based predominantly on CKD stage. This results in a significant proportion of patients with stable renal function being seen by nephrology, and in the under-referral of a large cohort of patients with progressive CKD.