Nephrology

Scope

• Evaluate and treat patients with renal insufficiency, significant proteinuria, past renal transplant, SLE with possible nephropathy, and refractory hypertension.

Appropriate patients for referral include:

• Renal Insufficiency (men Cr ≥ 1.4, women Cr ≥ 1.2 or SLE with any increase)
• Proteinuria ≥ 500mg/day (urine protein/urine creatinine ratio ≥ 0.5)
• Uncontrolled Hypertension (persistent SBP ≥ 160 despite compliance with 3 or more antihypertensive medications)
• Renal Transplant
•  SLE with abnormal urinalysis or increased creatinine
• Referral for Chronic Kidney Disease / elevated serum creatinine need the following labs:
  • urine protein/creatinine ratio 
  • phosphorus 
  • PTH 

Please do NOT refer the following patients:

• Kidney stones (refer to Urology Clinic.)
• Hematuria with normal renal function and no proteinuria (refer to Urology Clinic)
• Proteinuria on dipstick alone (must have qualitative urine protein/urine creatinine ratio ≥ 0.5)
• Pediatric patients (age<18)

Documentation required for scheduling an appointment:

• Completed Referral form
• Past Medical History (PMH)
• Current medication list
• Most recent progress note describing condition for which patient is being referred.
• Labs need to be within 1 month at the time of referral
• Renal ultrasound need to be within last 6 months
• Retinal exam need to be within last 2 years
• For Hospital and ER follow up, lab work 48 hours before appointment date

Revised May 2015

Download Nephrology Worksheet

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