Chronic Kidney Disease

Availability

North South North West Statewide

Pre-referral work-up

History

The following people should be considered for referral to the renal clinic:

  • eGFR < 30mL/min/1.73m2 (including  all people with a kidney transplant or dependent on dialysis)
  • New onset Nephrotic Syndrome (Oedema, Hypoalbuminaemia, Proteinuria>3.5g/24hr)
  • Unexplained decline in kidney function (> 25% drop in eGFR over three months)
  • Proteinuria > 1g/24hrs- particularly in non-diabetics
  • Glomerular haematuria (particularly if proteinuria present)
  • Potential kidney donors

The following people may be considered for referral to the renal clinic:

  • Recurrent urine infection
  • Resistant Hypertension (on 3 or more agents)
  • Recurrent renal calculi

Tests

  • FBC
  • UEC including e GFR
  • LFT
  • Comprehensive metabolic panel (includes calcium, magnesium, phosphate, urea, bicarbonate, chloride, blood glucose)
  • Consider lipids
  • Urine albumin/protein quantification (Generally Urine ACR)
  • Consider renal ultrasound if anatomical imaging needed

Interim/GP management

To refer a patient with this condition, please see the Nephrology (Renal) clinic page for the full referral process and templates.

Refer to the Kidney Association guidelines:   

  • Pay attention to cardiovascular risk reduction
  • Use ACE inhibitors or ARBs if possible
  • Monitor three to six monthly as per protocol in guidelines

For more information please see the Tasmanian Health Pathways website.

Emergency

Acute presentation and signs of acute glomerulonephritis

Urgent / category 1

(Glomerular Haematuria) Presence of Proteinuria and Haematuria with associated rapid unexplained decline in kidney function (>25% decline in GFR over 6-12 weeks)

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention.  They may or may not indicate an emergency.Refer to the Kidney Association Guidelines

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489 OR contact Renal Advanced Trainee or Nephrologist on Service via RHH Switchboard (03) 6222 8303 to facilitate urgent review/advice

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment