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May 16.2026
2 Minutes Read

How Low Nephrology Referral Rates Impact ASCVD and Kidney Health

How Low Nephrology Referral Rates Impact ASCVD and Kidney Health


Why Nephrology Referrals Matter for Patients at Risk

In the realm of kidney health, timely intervention is crucial. For patients with chronic kidney disease (CKD) and a heightened risk for atherosclerotic cardiovascular disease (ASCVD), nephrology referrals can be the difference between managing their health successfully and facing severe complications. Unfortunately, many patients at significant risk are falling through the cracks.

Understanding the Referral Gap

Recent findings presented at the National Kidney Foundation Spring Clinical Meetings revealed the stark reality that over half of patients at risk for ASCVD and kidney failure don’t get the referrals they need. Sharlene Shirali, a medical student at UCSF, reported that primary care providers often prioritize patients with advanced disease, leaving those who might benefit from referral unaddressed. “This triaging may lead to lower referral rates for patients who are viewed as clinically stable,” Shirali noted.

Implications of Low Referral Rates

Statistics paint a troubling picture. Among nearly 7,400 primary care patients surveyed, more than 58% were found to be at intermediate to high risk for developing ASCVD within a decade. Alarmingly, over 90% of those with CKD stages 3 to 5 exhibited low risks for kidney failure but were still overlooked for essential nephrology consultations. This gap is significant, as early nephrology intervention can lead to improved outcomes for complex patients.

The Challenge of Healthcare Access

Access to nephrology care is hindered by several barriers. Limited specialist capacity and extended wait times play a role, but there’s a broader context: the coordination between primary care and nephrology often falls short. Patients frequently lack awareness of their kidney health risks, leading to delays in seeking care. As the Strive Health model illustrates, implementing targeted outreach can successfully bridge this gap.

Improving Outcomes Through Better Coordination

Strive Health's innovative approach sheds light on effective strategies for connecting patients with necessary nephrology services. Their focus on risk stratification involves assessing various data points, from demographic information to lab results, enabling primary care providers to identify patients in dire need of specialist care. By embedding nephrologists into the patient management process, Strive is closing the referral gap—92% of participants in their program successfully connected with nephrologists in just 12 months.

What This Means for Concierge Medical Practices

For concierge medical practice owners seeking to establish themselves as leaders in patient care, understanding and addressing the gaps in nephrology referrals can enhance their practice’s reputation and patient loyalty. By proactively connecting at-risk patients with specialists, practice owners not only improve health outcomes but also position themselves as a trusted healthcare resource within the community.

Take Action: Empower Your Patients

The need for proactive health management has never been clearer. As a concierge medical practice owner, consider implementing a referral framework that prioritizes nephrology consultations for patients at risk. Engage with your patients, educate them about kidney health, and ensure they are not among those who miss out on necessary care. Every referral can make a meaningful difference in their lives.


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