Glomerular Disease
Emergency department referrals
- Urgent cases can be discussed at any time with either the Consultant on call or the Kidney Registrar rostered to the kidney ward (inpatients) can be contacted by ringing the Royal Brisbane and Women's Hospital on (07) 3646 8111.
If any of the following are present:
Adult
NB: Please call your local nephrology service if there is any doubt regarding the urgency of referral for an unwell patient
- Suspected Glomerular Disease (proteinuria and haematuria) with acutely declining kidney function or patient systemically unwell
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Acute glomerulonephritis (proteinuria and haematuria) with a decline in kidney function (>25% decline in eGFR within 6-12 weeks))
NB: Please call your local nephrologist if any doubt of urgency of acute referral as direct ward admission may be considered.
Category 2
Appointment within 90 days is desirable
- Previously diagnosed chronic glomerulonephritis patient requiring ongoing specialist follow up
Category 3
Appointment within 365 days is desirable
- No Category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
- Refer to Healthpathways or local guidelines
- Please call your local nephrologist if any doubt of urgency of acute referral as direct ward admission may be considered.
- Please consider multi system involvement especially possibility of pulmonary haemorrhage
Clinician resources
Patient resources
Referral requirements
A referral may be rejected without the following information.
- Presence of comorbid conditions such as SLE or other autoimmune condition, hypertension, diabetes, vascular disease or known chronic kidney disease
- List of medications and allergies
- FBC & ELFT results
- Serial urea, creatinine & eGFR results
- Urine albumin creatinine ratio (ACR) or urine protein creatinine ratio (PCR) (ideally early morning sample but a random sample is acceptable)
- Urine midstream M/C/S (including testing for red cell morphology, casts and crystals preferable)
- Recent BP results
Additional referral information
- Timeline of symptoms
- Ethnicity (Aboriginal and Torres Strait Islander population especially at risk)
- Family history of kidney disease
- Examination findings including oedema, rash, recent throat infection, other systemic findings
- Ultrasound (kidney, ureters & bladder) or alternative renal imaging results
- Other supportive investigative tests if indicated including:
- ANCA, ANA, ENA & anti DNA Abs (if suspected or confirmed autoimmune condition that may impact on kidney function)
- Hepatitis B/C serology especially if proteinuria
- Paraprotein testing eg FLC, SEPP, urine BJP if myeloma suspected
- Complement C3/C4
- Anti GBM antibodies
- Anti-streptococcal antibodies
- Kidney biopsy report (if previously performed)
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org