What do we do?
Our Nephrology teams provide care for patients with Kidney Disease based on Kidney Health Australia Guidelines. We provide twice weekly Renal clinics to address need for CKD patients. Renal education sessions are also run during the year to educate regarding kidney disease and planning.
Who do we care for?
We care for Adult patients with:
- Patients with Progressive Chronic Kidney disease
- Moderate to severe chronic kidney disease
- Proteinuria & Haematuria, Not related to Urological (anatomical) disorders
- Resistant Hypertension due to Kidney disease
- Planning and Maintenance of patient on Renal Replacement Therapies including Renal Transplant and Dialysis
- Patients Conservative care to End Stage Kidney disease patients
- Genetic and hereditary Kidney Disease
- Work up of potential Renal Transplant Donor and Recipient
What can you expect?
Patients can expect an initial assessment and follow up visit if needed.
Some condition require repeat visits for monitoring and for specialist to organise further testing and prescriptions for certain medications.
Referral for Dialysis and Transplant education if required.
How can you access this service?
A valid referral with recent investigations from your General Practitioner or Specialist is required. Referrals are also accepted from different medical and surgical units in hospital.
Each referral will be assessed based on greatest need and urgency for appointment.
Grampians Health Ballarat provides 2 Renal clinics per week. Renal MBS clinic for early stages CKD and Wednesday unit Med B clinic for advanced CKD.
Dedicated Renal Consult team operate within the hospital for acute renal referrals.
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
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.
Ballarat Base Hospital
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