Timely Referral to Outpatient Nephrology Care Slows Progression and Reduces Treatment Costs of Chronic Kidney Diseases Gerhard Lonnemann, Johannes Duttlinger,

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Timely Referral to Outpatient Nephrology Care Slows Progression and Reduces Treatment Costs of Chronic Kidney Diseases Gerhard Lonnemann, Johannes Duttlinger, David Hohmann, Lennart Hickstein, Helmut Reichel Kidney International Reports Volume 2, Issue 2, Pages 142-151 (March 2017) DOI: 10.1016/j.ekir.2016.09.062 Copyright © 2016 International Society of Nephrology Terms and Conditions

Figure 1 Frequency matching for gender and age using 5-year intervals. The paired bars represent the percentage of patients in the particular age group. Total numbers of women and men and mean ages ± SD are given. Kidney International Reports 2017 2, 142-151DOI: (10.1016/j.ekir.2016.09.062) Copyright © 2016 International Society of Nephrology Terms and Conditions

Figure 2 Hospital admission rates per patient per year. Bars represent the median (min/max) of n = 4 years (2009–2012) for patients with CKD3–5 and dialysis treatment. P values are given for comparison of the paired bars. The median (min/max) numbers of patients timely versus late were, for CKD3, n = 6724 (5759/8151) versus n = 5137 (4219/6128); for CKD4, n = 1682 (1395/1988) versus n = 1064 (728/1392); for CKD5, n = 447 (361/548) versus n = 259 (181/316); and for hemodialysis, n = 2593 (2521/2695) versus n = 778 (616/909). CKD, chronic kidney disease. Kidney International Reports 2017 2, 142-151DOI: (10.1016/j.ekir.2016.09.062) Copyright © 2016 International Society of Nephrology Terms and Conditions

Figure 3 Total costs per patient per year in Euro (€). Bars represent the median (min/max) of n = 4 years (2009–2012) for patients with CKD3–5 and dialysis treatment. P values are given for comparison of the paired bars. For numbers of patients in the analyzed groups, see the legend of Figure 2. CKD, chronic kidney disease. Kidney International Reports 2017 2, 142-151DOI: (10.1016/j.ekir.2016.09.062) Copyright © 2016 International Society of Nephrology Terms and Conditions

Figure 4 Total number of patients with stable kidney function in transition from one year to the next. Mean percentages of patients with stable disease in the 2 groups are given in the table underneath. P values are depicted. CKD, chronic kidney disease. Kidney International Reports 2017 2, 142-151DOI: (10.1016/j.ekir.2016.09.062) Copyright © 2016 International Society of Nephrology Terms and Conditions

Figure 5 Stability of kidney function, start of dialysis, and mortality in patients starting with CKD stage 3. The bars represent the means ± SD of n = 3 transitions from one year to the next (2009/2010, 2010/2011, 2011/2012). P values for significant changes are given, for comparison of the paired bars. The numbers of patients timely versus late were 3934 versus 2337, 4830 versus 2600, and 6132 versus 3437 for the 3 time points. CKD, chronic kidney disease. Kidney International Reports 2017 2, 142-151DOI: (10.1016/j.ekir.2016.09.062) Copyright © 2016 International Society of Nephrology Terms and Conditions

Figure 6 Kaplan-Meier analysis on the probability of patient survival in patients with CKD3 starting in 2009. The numbers at risk are depicted in the table underneath. The log rank is highly significant with P = 0.0001. CKD, chronic kidney disease. Kidney International Reports 2017 2, 142-151DOI: (10.1016/j.ekir.2016.09.062) Copyright © 2016 International Society of Nephrology Terms and Conditions