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Renal/Nephrology

Find assessment and management information on Renal/Nephrology conditions at:

Emergency Immediate transfer to the Emergency Department

  • 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+ >6.5mmol/L OR >6.0mm/L with ECG changes
    • Hypokalemia with K+ <2.5mmol/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
  • Kidney transplant recipients with acute intercurrent illness
  • Suspected glomerulonephritis (proteinuria and haematuria) with acutely declining kidney function or patient systemically unwell
  • 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
  • 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
  • Severe macroscopic haematuria 
  • Suspected urolithiasis/nephrolithiasis with infection and severe pain
  • Suspected urinary retention/obstruction (eg anuria, oliguria)
  • Hypertensive emergency (for example BP> 220/140)
  • Severe hypertension 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
  • Nephrotic syndrome (proteinuria >3.5grams/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 
       

Are you referring to the right service?

  • Queries regarding potential live donor referrals should be directed to the Transplant coordinators on PAHRenalTransplantCoordinators@health.qld.gov.au located at Princess Alexandra Hospital. The transplant coordinators can assist in the initial assessment and referral for these patients and should be contacted early in the process. 
  • Haematuria: Refer to Haematuria flowchart (PDF, 191.45 KB) for guidance in determining whether to refer to Urology or Nephrology
     

Urgent referrals Arranging urgent review

To arrange an urgent outpatient appointment, please phone the relevant hospital’s switchboard and ask to speak to the Registrar of the relevant specialty.

Out of scope services

There are no out of scope services for Nephrology 

Notes

  • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
  • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Out of catchment

Metro South 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 South 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.

Last updated 26 July 2019