To ensure that our resources are directed towards those in most need we have a selection criteria to determine what problems can be seen in our clinic. The below information is mainly for GPs and other referring clinicians.
Indications for urgent referral to local Emergency Department:
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 and the patient referred to the emergency department
Inclusion Criteria:
Presenting Complaint
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When to Refer
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eGFR <30ml/min/1.73m2 (stage 4 or 5 CKD of any cause)
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Patient comorbidities should be taken into account when referrals are made. Elderly patients when GFR <30 may not need a Nephrology review while younger patients may need referral earlier.
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Persistent significant albuminuria
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Urine ACR>30mg/mmol demonstrated twice within 3 months
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Haematuria
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Usually 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.
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Sustained decrease in eGFR
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A 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
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Hypertensive/CKD disorders of pregnancy
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Pre-conception counselling and management Management during pregnancy
Postpartum review
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CKD with hypertension or resistant hypertension
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Difficult to control despite at least 3 antihypertensive agents or suspected secondary cause of hypertension
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Renal stones
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2 or more renal stones
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Renal transplant patient
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All renal transplant patients should be regularly seen by a Nephrologist
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Renal transplant donor
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All past transplant donors and potential donors should be seen by a Nephrologist
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Patient with ESKD opting for a non dialytic supportive care pathway
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Patients for renal supportive careshould be referred to a Nephrologist initially
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Dialysis patient
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All dialysis patients should be regularly seen by a Nephrologist
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Out of NSLHD:
• Reason must be stated explicitly
• Resident of other LHD that does not provide the clinical service
• Continuing care of existing condition already managed by NSLHD
• Demonstrated complexity requiring services of NSLHD
• Compassionate circumstances, e.g. family, proximity, staff
A referral from GP is required to make an appointment for a clinic. The following information must be included for referral to be accepted:
• Date and duration of referral (referrals accepted for either a 12-month period or indefinite)
• Referrer's name, address, provider number and signature
• Patient's details - name, date of birth, address, phone numbers, Medicare number/Department of Veteran Affairs 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, e.g. Cardiologist
Some of the following tests may be required before an appointment is made:
• Blood chemistry and haematology
• Urinary Albumin/creatinine ratio and urine microscopy for red cell morphology and casts
• Renal tract ultrasound
Providing more information will aid the triage process and make it more likely that your patient will be seen in the most timely manner possible.
Please submit referrals using the eReferral system through HealthLink, which can be accessed through most clinical software systems.
Referrals will be triaged and your patient will be notified of the outcome as soon as possible. This process may take between 1-4 weeks. You will be contacted if more information is needed.
Telehealth services are available, please indicate on the referral if you feel this would be suitable for your patient’s appointment.