When Should You Refer A Patient to Peninsula Kidney Associates?
These conditions require nephrology intervention in a timely fashion:
- Patients with eGFR < 60 and concomitant proteinuria, hematuria and/or pyuria
- Patients with eGFR < 60 and his/her GFR has been declining
- Patients with advanced CKD who will need extensive education for possible kidney transplant and different dialysis modalities
- Incidental diagnosis of polycystic kidney disease on imaging studies such as ultrasound, CT or MRI
- Unexplained proteinuria, quantitated greater than 500 mg/day
- Nephrotic syndrome (with heavy proteinuria, edema, hypoalbuminemia, hyperlipidemia) +/- hypertension
- Patients with the combination of proteinuria and hematuria or pyuria, even when proteinuria is low-grade.
- Unexplained hematuria. Patients with newly discovered hematuria +/- proteinuria may have underlying acute glomerulonephritis, which requires rapid work-up and treatment, even when creatinine/eGFR appear normal.
- Patients who have a kidney transplant
- Worsening blood pressure control in a previously stable patient
- Resistant hypertension in a patient under the age of 35, in a patient on 3 or more antihypertensive medications, or in a patient with any degree of kidney disease
- Recurrent kidney stones
- Diabetes mellitus with proteinuria and/or difficult-to-control hypertension
- Patients with a history of nephrectomy and/or a solitary kidney who have any degree of renal insufficiency
- Recurrent electrolyte abnormalities such as hyponatremia, hypercalcemia, hyper/hypokalemia, hypomagnesemia, and acid base disturbances, among others
- Refractory edema
- Pregnant women 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 eGFR