Chronic Kidney Disease

This condition is treated in the Nephrology (Renal) clinic.

Pre-referral work-up

History

The following people should be considered for referral to the renal clinic:

• eGFR under 30mL/min/1.73m² (including all people with a kidney transplant or dependent on dialysis)
• New onset Nephrotic Syndrome (Oedema, Hypoalbuminaemia, Proteinuriaover 3.5g/24hr)
• Unexplained decline in kidney function (over 25% drop in eGFR over three months)
• Proteinuria over 1g/24hrs- particularly in non-diabetics
• Glomerular haematuria (particularly if proteinuria present)
• Potential kidney donors

The following people may be considered for referral to the renal clinic:

• Recurrent urine infection
• Resistant Hypertension (on 3 or more agents)
• Recurrent renal calculi

Tests

• FBC
• UEC including e GFR
• LFT
• Comprehensive metabolic panel (includes calcium, magnesium, phosphate, urea, bicarbonate, chloride, blood glucose)
• Consider lipids
• Urine albumin/protein quantification (Generally Urine ACR)
• Consider renal ultrasound if anatomical imaging needed

Interim/GP management

To refer a patient with this condition, please see the Nephrology (Renal) clinic page for the full referral process and templates.

Refer to the Kidney Association guidelines:   

• Pay attention to cardiovascular risk reduction
• Use ACE inhibitors or ARBs if possible
• Monitor three to six monthly as per protocol in guidelines

For more information please see the HealthPathways Tasmania website.

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention.  They may or may not indicate an emergency.Refer to the Kidney Association Guidelines

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

? Acute presentation and signs of acute glomerulonephritis

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

? (Glomerular Haematuria) Presence of Proteinuria and Haematuria with associated rapid unexplained decline in kidney function (over 25% decline in GFR over 6-12 weeks)

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Phone: 03 6477 7746
Fax: 03 6777 5214

North West Regional Satellite Service

1 Strahan Street

South Burnie TAS 7230

South

Wellington Clinics
Phone: 03 6166 0000
Fax: 03 6234 3982