For Health Professionals

Overview

Our dedicated Renal Consult team operates within the Ballarat Base Hospital for acute renal referrals. 

Referral process

  • Smart referral 
  • See ‘Referral criteria’ below for referral requirements and recommended tests

Urgent renal referrals

Urgent renal conditions such as: 

  • renal transplant 
  • haemodialysis or peritoneal dialysis patient with acute intercurrent illness requiring inpatient admission 
  • major metabolic disturbances e.g. Hyperkalaemia or severe acidosis 
  • acute nephrotic or nephritic syndrome due to acute glomerulonephritis 

can be discussed with Renal Registrar through switchboard 03 5320 4000. 

Referral criteria

Referral to a specialist renal service or Nephrologist is recommended in the following situations: 

  • Persistent eGFR <30mL/min (stage 4 or 5 CKD of any cause) 
  • Persistent significant albuminuria (urine ACR >30 mg/mmol) on 2 early morning urine samples > 3 months apart. 
  • A sustained decreased in eGFR of 25% or more OR a sustained decrease in eGFR of 15mL/min within 12 months 
  • Severe Persistent Hypertension >180/110 or resistant hypertension > 140/90 with 3 or more antihypertensive or suspected Secondary hypertension eg. CKD or Renal artery stenosis 
  • Glomerular haematuria (proven on Urine Phase contrast microscopy and cast analysis) with proteinuria. After excluding Lower Urinary tract conditions and Cytology testing 
  • Anaemia associated with Kidney disease when Haematinics deficiency and haematological causes has been ruled out. 
  • Preparation and regular review for patient on Renal Replacement therapies Dialysis or Transplant 
  • Conservative care approach to End Stage Kidney Disease 
  • Dialysis Education 

Referral is not necessary if

  • Stable eGFR >30mL/min 
  • Urine ACR <30mg/mmol (no haematuria) 
  • Controlled blood pressure 
  • Renal calculi requiring Urological management 
  • Renal anatomical lesions including cysts in particular complex cysts that require direct referral to urology 
  • Issues related to renal obstruction, please refer to urology unit 

Tests recommended prior to referral

  • Current Blood Chemistry and Haematology: Full blood count, Urea and electrolytes, Liver function tests, Calcium Phosphate and Magnesium, Fasting Glucose, Lipids and if indicated HbA1c 
  • Spot Urine Albumin creatinine ratio or Protein creatinine ratio and Urine Microscopy for Ref Cell Morphology and casts 
  • Renal Tract Ultra Sound 
  • Current and historic Blood pressure records 
  • Current List of medications and list of medical and surgical history 

Clinic sessions

Two renal clinics are held per week at Ballarat: Tuesday & Wednesday afternoon 

  • Renal MBS clinic for early stages CKD  
  • Wednesday unit Med B clinic for advanced CKD