Routine referral

Recommended for any one of the following:

  • eGFR < 30 mL/min/1.73m2 , irrespective of albuminuria or hematuria.
  • Persistent albuminuria (ACR > 60 mg/mmol), irrespective of hematuria (2-3 samples over 2-4 weeks).
  • Hematuria sustained (2-3 samples over 2-4 weeks) and not readily explained by a urinary tract source with:
    • »  Persistent albuminuria (ACR 3 – 60 mg/mmol) irrespective of eGFR
    • - or -
    • »  eGFR < 60 mL/min/1.73m2
  • An unexplained, progressive decline in eGFR ≥ 5 mL/min/1.73m2 that occurs over 6 months, confirmed on repeat testing within 2-4 weeks (ACEi or ARBs can cause a reversible reduction in eGFR when initiated).

Urgent referral

Recommended for any one of the following:

  • Rapid decline in eGFR over days to weeks.
  • eGFR declining over weeks to months PLUS hematuria and/or albuminuria.
  • eGFR < 15 mL/min/1.73m2.
  • Acute nephrotic syndrome (ACR > 180 mg/mmol or proteinuria > 3g/d).
  • Suspected vasculitis / autoimmune disease in the setting of hematuria and/or albuminuria.

Emergent referral

Recommended for any one of the following:

  • New diagnosis of eGFR < 10 mL/min/1.73m2 .
  • Life threatening uremic symptoms (marked hyperkalemia > 6.5 mmol/L; pulmonary edema and kidney failure; pericarditis and kidney failure).

Referral could be considered for any one of the following:

  • CKD and hypertension refractory to treatment with 4 or more antihypertensive agents.
  • Persistent abnormalities of serum potassium or other electrolytes.
  • Recurrent or extensive nephrolithiasis.
  • Hereditary kidney disease (e.g. polycystic kidney disease).

If you are concerned about a patient that does not fall within these categories contact the nephrology group in your area.

Download Referral Form (PDF)

Download Nephrology Referral Locations (PDF)

Specific tests / investigations required with referral:

  • Recent serum creatinine / eGFR (including multiple measurements over previous years).
  • Recent routine urinalysis.
  • Recent random urine albumin:creatinine ratio (ACR).
Download Download specific test info (PDF)