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Summary of Referral Criteria


Summary of Referral Criteria to Renal Medicine

 

According to eGFR (ml/min/1.73m2  
<15  Immediate referral or discussion
15-29  Urgent referral or discussion, or routine if known to be stable
30-59

 Routine referral indicated if:

  • Progressive fall in eGFR/rise in serum Creatinine
  • Isolated invisible asymptomatic haematuria
  • Proteinuria if ACR >70mg/mmol
  • Unexplained anaemia (Hb <11.0g/l)
  • Suspected systemic illness (eg SLE)
  • BP > 140/90 despite appropriate treatment
60+  Referral not required unless other evidence of kidney disease (eg likely genetic diagnosis, urinary abnormalities, see below)

 

Other Indications for Referral

 

Acute renal failure Immediate referral/discussion - most patients with acute renal failure unless the cause and solution are obvious
 Proteinuria Routine referral - urine ACR > 70mg/mmol or >30mg/mmol with invisible haematuria

Urgent referral - heavy proteinuria with low serum albumin (nephrotic syndrome)

Haematuria Routine referral - haematuria with negative urological investigations or invisible heamaturia with ACR >30
Hypertension Immediate referral - malignant hypertension

Routine referral - uncontrolled BP (>140/90 on appropriate treatment) and CKD 3 or more

Hyperkalaemia Immediate referral - Potassium > 7