Information for Referring Doctors
Items Needed for Referrals
We prefer that all patients be referred by a physician.
• Demographic face sheet
• Last 1-2 years of blood work and urine studies
• Last 1-2 office visit notes
• Any Abdominal or Renal Ultrasounds, and/or CT Abdomen/Pelvis
When to Refer Patients
We recommend referral to a nephrologist in the following circumstances, even if the primary care doctor has done an extensive workup:
• Acute kidney injury or abrupt sustained fall in GFR
• GFR <30 ml/min/1.73m2
• Persistent proteinuria (Protein to Creatinine Ratio >0.5mg/mg or 24 hour protein urine >500mg/24 hours or Albumin to Creatinine Ratio >300mg/g or 24 hour Albumin urine >300mg/24 hours)
• Progression of CKD (A decline in GFR category accompanied by 25% or greater drop in eGFR from baseline and/or rapid progression of CKD defined as a sustained decline in eGFR or more than 5ml/min/1.73m2/year)
• Nephrotic Syndrome (heavy proteinuria, edema, hypoalbuminemia, hyperlipidemia, and/or hypertension)
• Patients with a combination of proteinuria and hematuria
• Urinary red cell casts, RBC > 20 per high power field sustained and not readily explained
• Severe or uncontrolled hypertension in a person on 4 or more antihypertensive medications
• Persistent abnormalities of serum potassium
• Persistent abnormalities of serum sodium
• Recurrent or extensive nephrolithiasis
• Incidental diagnosis of polycystic kidney disease on Ultrasound, CT or MRI
• Patients with a history of nephrectomy and/or a solitary kidney who have any degree of kidney insufficiency
• Pregnant woman with any degree of kidney disease
There are some common conditions that generally do not require Nephrology consultation:
• Solitary simple renal cysts
• Controlled hypertension in the absence of diabetes and/or abnormal calculated GFR
We prefer that all patients be referred by a physician.
• Demographic face sheet
• Last 1-2 years of blood work and urine studies
• Last 1-2 office visit notes
• Any Abdominal or Renal Ultrasounds, and/or CT Abdomen/Pelvis
When to Refer Patients
We recommend referral to a nephrologist in the following circumstances, even if the primary care doctor has done an extensive workup:
• Acute kidney injury or abrupt sustained fall in GFR
• GFR <30 ml/min/1.73m2
• Persistent proteinuria (Protein to Creatinine Ratio >0.5mg/mg or 24 hour protein urine >500mg/24 hours or Albumin to Creatinine Ratio >300mg/g or 24 hour Albumin urine >300mg/24 hours)
• Progression of CKD (A decline in GFR category accompanied by 25% or greater drop in eGFR from baseline and/or rapid progression of CKD defined as a sustained decline in eGFR or more than 5ml/min/1.73m2/year)
• Nephrotic Syndrome (heavy proteinuria, edema, hypoalbuminemia, hyperlipidemia, and/or hypertension)
• Patients with a combination of proteinuria and hematuria
• Urinary red cell casts, RBC > 20 per high power field sustained and not readily explained
• Severe or uncontrolled hypertension in a person on 4 or more antihypertensive medications
• Persistent abnormalities of serum potassium
• Persistent abnormalities of serum sodium
• Recurrent or extensive nephrolithiasis
• Incidental diagnosis of polycystic kidney disease on Ultrasound, CT or MRI
• Patients with a history of nephrectomy and/or a solitary kidney who have any degree of kidney insufficiency
• Pregnant woman with any degree of kidney disease
There are some common conditions that generally do not require Nephrology consultation:
• Solitary simple renal cysts
• Controlled hypertension in the absence of diabetes and/or abnormal calculated GFR
