Existing renal research into late referral has not fully explored the range of potential health determinants that may affect: (a) the timing of nephrology referral; and (b) the consequences of late referral for patient health status. Using secondary data on British Columbia renal patients who began dialysis between April 2000 and March 2003 (N = 2001), this thesis draws on a "determinants of health" perspective to assess the impact of a variety of factors on the timing of renal patients´ nephrology referral and, subsequently, their utilization of renal-related hospital and medical services. The factors studied include measures of patients´ physical health (cause of renal disease), individual demographics (gender, age, race/ethnicity measures), socioeconomic status (income), social support (marital status, availability of next-of-kin), and geographic and health system characteristics (proximity to care, patient´s dialysis centre)---all of which may be considered to be poten