The Department of Renal Medicine at Royal North Shore Hospital provides a comprehensive nephrology service to the population of Northern Sydney Local Health District.   

Services include, but are not limited to general nephrology, hypertension, haemodialysis (inpatient including intensive care and coronary care, in-centre, satellite, home training and follow up), CAPD (inpatient, home training and follow up), renal transplantation (donor and recipient work up, pre operative care, surgery and post operative and outpatient care), high risk pregnancy (pre-eclampsia) and renal biopsy. 

The Department of Renal Medicine runs several outpatient services on a weekly basis.   

Royal North Shore Hospital provides the following Renal clinics:

  • General Nephrology
  • Hypertension
  • Hypertension and  CKD disorders of pregnancy
  • Renal Stone Disease
  • Dialysis
  • Renal Transplant
  • Renal Supportive Care

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Referral

A valid GP or Specialist referral is required for all services provided in the clinic – please visit your GP for an assessment if you feel a referral may be required. If you are a GP or Specialist wishing to make a referral, please use the below contacts.

Mandatory referral information

All Renal referrals must include a named consultant being referred to in RNSH outpatients. If unsure, please address referral to Dr Amanda Mather and Associates.

All patients who are referred to the Kidney Clinic must have relevant investigations prior to an appointment being made, with results sent with the referral:

  • Blood chemistry and haematology (at the minimum, UEC, LFT, FBC but Uric Acid, CaMgPo4, Iron studies, PTH may also be required)
  • Urinary Albumin/creatinine ratio and urine microscopy for red cell morphology and casts
  • Urinary tract ultrasound

All referrals must also include:

  • Date and duration of referral (referrals accepted for either a 12 month period or indefinite)
  • Referrer's name, address, provider number and signature
  • Patients details – name, date of birth, address, phone numbers, Medicare number/DVA number
  • Provisional diagnosis and reason for referral
  • Finding/treatment to date
  • Significant medical history
  • List of medications
  • Relevant social information
  • Need for interpreter and preferred language
  • If applicable, the most recent letter from any other physician, eg Cardiologist

Referrals with insufficient information will be returned to the GP until further information is provided to the clinic.

Urgent cases

For referrer use only.

The following conditions should be actioned immediately:
Refer directly to the Emergency Department:

  • Major metabolic disturbance (hyperkalaemia or severe acidosis)
  • Hypertension emergency

Discuss urgently with the on-call renal physician or registrar with consideration of referral to the Emergency Department:

  • Anyone with a rapidly declining eGFR and/or signs of acute glomerulonephritis (oliguria, haematuria, acute hypertension, and oedema)
  • Kidney transplant recipients with intercurrent illness
  • Chronic dialysis patients with intercurrent illness

For urgent assessments, the Department office should be contacted on 9463 1755 to discuss options.

Indications for Referral

For referrer use only. Any patients who feel they may require a referral must be assessed and referred by their GP if appropriate.
Presenting complaintWhen to Refer
eGFR <30ml/min/1.73m2 (stage 4 or 5 CKD of any cause)Patient comorbidities should be taken into account when referrals are made. Elderly patients with eGFR <30 may not need a Nephrology review while younger patients may need referral earlier.
Persistent significant albuminuriaUrine ACR>30mg/mmol demonstrated twice within 3 months
HaematuriaUsually refer to urology (see local guidance for referral pathways). If associated with renal impairment, proteinuria,  hypertension or family history of renal disease, consider simultaneous referral to the Kidney Clinic.
Sustained decrease in eGFRA sustained decrease in eGFR of 25% or more OR a sustained decrease in eGFR of 15ml/min/1.73m2 within 12 months
Note: Anyone with a rapidly declining eGFR and/or signs of acute glomerulonephritis is considered urgent and contact should be made with the on-call Renal physician immediately
Hypertensive/CKD disorders of pregnancyPre-conception counselling and management
Management during pregnancy
Postpartum review
CKD with hypertension
or resistant hypertension
Difficult to control despite at least 3 antihypertensive agents or suspected secondary cause of hypertension
Renal stones2 or more renal stones
Renal transplant patientAll renal transplant patients should be regularly seen by a Nephrologist
Renal transplant donorAll past transplant donors and potential donors should be seen by a Nephrologist
Patient with ESKD opting for a non dialytic supportive care pathway​Patients for renal supportive care should be referred to a Nephrologist initially and then an internal referral can be made
Dialysis patient

​All dialysis patients should be regularly seen by a Nephrologist

 

The RNSH Kidney Clinic is unable to provide a service for the following conditions:

  • Under 16 years of age

Please refer the following to Urology (see Urology Clinic Criteria document for further information):

  • Suspicious renal lesions
  • Elevated PSA
  • Flank pain unless known polycystic kidney disease

Out of Area Referral

The RNSH Kidney clinic provides services to patients living within the Northern Sydney Local Health District. Exceptions to this are outlined below.

Resident of Northern Sydney Local Health District Catchment ​Yes - referral accepted at RNSH
Referral from other specialist, for specialist opinion​Yes - referral accepted at RNSH
Resident of other Local Health District that DOES NOT provide the clinical service e.g. rural, outer metro​Yes, but service or problem needs to be documented on referral
Continuing care of existing condition we already manage​Yes, provided existing or related condition documented on referral
Demonstrated complexity requiring services of Royal North Shore Hospital Kidney Clinic​Yes but must be explicitly documented on referral
Compassionate circumstances (e.g. family proximity, staff)​Yes but must be explicitly documented on referral
Resident of other LHD that offers the service​Refer to your Local Health District


Check if the home address is within Northern Sydney Local Health District here: https://www.health.nsw.gov.au/lhd/Pages/lhd-maps.aspx

RNSH consultant referral options

The following Renal Specialists work at the RNSH Kidney Clinic. Some also work in other locations, including:

  • Private rooms - which patients can be referred to and usually have a shorter waiting period. There will likely be an out of pocket cost for the consultation.
  • An outreach General Nephrology Clinic at the Hornsby Kuring-gai Hospital (HKH). Please consider referral to this hospital for appropriate local patients (note: management during pregnancy will be seen at RNSH). Ph: (02) 9485 6366,  Fax: (02) 9485 6056.
Consultant HKHRoomsLocation of rooms
Dr Amanda MatherNil
Dr Stella McGinnNil
Dr Emma O'LoneNil
Dr Susan WanNil
Dr Bruce CooperYesNil
Dr Sarah RoxburghYesNil
Prof Carol PollockPrivate roomsLevel 7, Kolling Building RNSH (St Leonards)
Ph: (02) 9926 4652, Fax: (02) 8078 0107
Dr Yvonne ShenPublic clinicNorthern Specialist Centre (St Leonards)
Ph: (02) 9463 1966; Fax: (02) 9463 2097
Dr Muh WongPrivate rooms

Northern Specialist Centre (St Leonards)

Ph: (02) 9463 1966; Fax: (02) 9463 2097

Sydney Kidney Urology Centre (Chatswood)

Ph: (02) 9411 8022; Fax: 9411 8300

Dr Stefanie StangenbergPrivate roomsLindfield  Ph: (02) 9416 8899; Fax: (02) 9416 5877
Dr Paul CollettPrivate rooms

Northern Specialist Centre (St Leonards)

Ph: (02) 9463 1744; Fax: (02) 9463 1084

Dr Vlado PerkovicPrivate rooms

Northern Specialist Centre (St Leonards)

Ph: (02) 9463 1966; Fax: (02) 9463 2097

Dr Sara Rendo
(Renal Supportive Care)
Nil

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Finding Us:
Kidney Clinic
Level 3 – Acute Services Building
Royal North Shore Hospital
St Leonards NSW 2065

Postal Address:
Department of Renal Medicine
3E Clinical Administration
Acute Services Building
Royal North Shore Hospital
St Leonards NSW 2065

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Kidney Clinics: Monday – Friday, 8am-4pm

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Patients:

Phone: (02) 9463 1755 Fax: (02) 9463 1055

Referral Email: NSLHD-RNS-Renal-Administration@health.nsw.gov.au

Clinic Location and Postal Address:
Department of Renal Medicine
Clinical Administration 3E
Royal North Shore Hospital
Reserve Rd
St Leonards 2065

Referrers:

Urgent referrals: Contact the RNSH Switchboard (9926 7111) and ask to page the on-call Renal Physician or registrar.

Routine referrals: Send a referral letter via email to NSLHD-RNS-Renal-Administration@health.nsw.gov.au or via fax to (02) 9463 1055. Referrals will be triaged to the appropriate clinic within the Kidney Clinic.