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 (Nephrotic range proteinuria and low suspicion of diabetic nephropathy).
  • 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).
  • Severe rapidly progressive glomerulonephritis (RPGN) (suspected ANCA/anti-GBM with positive serology), call nephrologist on call.

Referral could be considered for any one of the following:

  • 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) Download AHS Provincial Nephrology Referral Quick Reference (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)