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Renal Services (Kidney medicine / Nephrology)

Conditions

Paediatric services

Referrals for children and young people should follow the Children’s Health Queensland referral guidelines.

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

  • Any acute kidney injury or significant decline in kidney function where the treating doctor believes the patient requires urgent hospital care (especially if evidence of abrupt increase in serum creatinine by > 50% of baseline)
  • Oliguria/anuria
  • Severe acute electrolyte disturbance for example:
    • hyperkalemia with K+ > 6.5 mmol/L OR > 6.0 mmol/L with ECG changes
    • hypokalemia with K+ < 2.5 mmol/L OR < 3.0mmol/L with symptoms
    • severe metabolic acidosis (HCO3 < 15mmol/L)
  • Kidney transplant recipients with an acute decline in kidney function (e.g. > 20% increase in serum creatinine)
  • Suspected glomerulonephritis (proteinuria and haematuria) associated with acute kidney injury

  • Severe acute electrolyte disturbance for example:
    • hyperkalemia with K+ > 6.5 mmol/L OR > 6.0 mmol/L with ECG changes
    • hypokalemia with K+ < 2.5 mmol/L OR < 3.0mmol/L with symptoms
    • severe metabolic acidosis (HCO3 < 15mmol/L)
  • Severe hypertension especially when accompanied with declining kidney function
  • Patients with severe uraemic symptoms or signs
  • Evidence of acute fluid overload or heart failure in a patient with known CKD
  • Kidney transplant recipients with acute intercurrent illness
  • Peritoneal or haemodialysis patients with acute issues or problems with dialysis access (eg vascular access issues or peritoneal dialysis catheter issues)
  • Peritoneal dialysis patients with suspected peritonitis (abdominal pain, cloudy dialysis fluid)

  • Significant cyst haemorrhage, suspected septicaemia related to cyst infection, suspected rupture of berry aneurysm

  • Suspected glomerulonephritis (proteinuria and haematuria) with acutely declining kidney function or patient systemically unwell

  • Severe macroscopic haematuria

  • Hypertensive emergency (for example BP > 220/140)
  • Severe hypertension with systolic BP > 180mmHg with any of the following concerning features:
    • headache
    • confusion
    • blurred vision
    • retinal haemorrhage
    • reduced level of consciousness
    • seizures
    • proteinuria
    • papilloedema
    • signs of heart failure
    • chest pain

If suspected pregnancy induced hypertension or pre-eclampsia refer patient to the emergency department of a facility that offers obstetric services where possible.

  • Suspected urolithiasis / nephrolithiasis with infection or severe pain
  • Suspected urinary retention/obstruction (eg anuria, oliguria)

  • Nephrotic syndrome (proteinuria > 3.5 grams/24 hours OR urine ACR > 300mg/mmol* or PCR > 300g/mol*) with any of the following concerning features:
    • significant peripheral oedema
    • signs of pulmonary oedema
    • severe hypertension
    • signs of DVT / PE
    • infection
    • acute kidney injury

  • Kidney transplant patients with significant intercurrent illness (eg diarrhoea and vomiting)

Referral requirements

A referral may be rejected without the following information.

Clinical Modifiers (where relevant)

  • 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

Reason for Referral (essential)

  • 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

Clinical Information (essential)

  • 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

Patient’s Demographic Details (essential)

  • 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

Referring Practitioner Details (essential)

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

Other Information (where relevant)

  • 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.)

Specialists list

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

Locations

Resources

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