Referral Criteria to Renal Unit

Referring clinicians should follow the referral criteria below to allow appropriate prioritisation.

Routes of Referral

The renal on-call phone based at the Queen Elizabeth University Hospital (extension 82417 or 0141 452 2417) should be used for referrals. There are 3 options, ensure you select the appropriate option to limit delays.

Urgent Inpatient Referral (Renal Registrar- Option 3)

All emergency cases, or cases which directly affect patient care (e.g. missed dialysis sessions) should be phoned directly to the renal on-call registrar.

Non-Urgent Inpatient Referral (Renal Secretary (during working hours)- Option 2)

Renal secretarial staff will pass on non-urgent messages to the renal medical team for discussion. This option is most appropriate for patients known to the renal team, or for decisions on patient follow-up and is usually discussed with a consultant. N.B. A response will usually take 24-48 hours.

Renal Pharmacy Advice (during working hours)- Option 1

Advice relating to drug dosing, administration and interactions can be discussed. It is not appropriate to ask the pharmacy team to advise on clinical decisions e.g. whether a drug should be commenced or not.

Organising Transfer

  • Decision regarding appropriateness to transfer remains with the referring clinician.
  • In patients with multi-organ failure or evidence of significant respiratory failure and acute kidney injury (AKI), we recommend discussing the case with local critical or intensive care units.
  • The referring doctor must ensure the consultant in charge of the patient's care is aware of the referral.
  • It is the responsibility of the referring team to ensure that patients transferred for management of AKI from an area of specialist care organises ongoing input within the Queen Elizabeth University Hospital.
  • Important considerations in patient transfer are listed in table 1.
Table 1 – Important considerations in transferring patients with AKI
  • Hyperkalaemia - ideally <6.5mmol/L prior to transfer.
  • Risk of hypoglycaemia - from insulin / dextrose.
  • Oxygen requirement.
  • Cessation / reversal of anticoagulants - to allow lines.
  • Cardiovascular stability.
  • Paramedic / nursing escort.

 

Guideline reviewed: February 2023

Page last updated: March 2023