Acute renal failure

(Acute kidney injury and chronic kidney disease)

Red flags

Consider urgent referral for patients with the following

  • Haematuria associated with fever and or confusion
  • Unable to pass urine
  • Severe renal colic with inability to pass urine or reduced urine output
  • Hyperkalaemia (over 6.0)

Causes of Acute Renal Failure

  • Pre-Renal
    • Shock related
      • Post MI
      • Sepsis
      • Burns
      • Placental abruption
    • Dehydration
    • Interruption of blood flow
      • Emboli to renal arteries
      • Abdominal aortic aneurysm/dissection
  • Renal
    • Infection related
      • Acute pyelonephritis
    • Drug related
      • Aspirin, NSAIDs
    • Trauma
      • Direct to kidneys
      • Secondary to shock
      • Massive muscle damage
    • Rhabdomyolysis
  • Post Renal
    • Outflow Obstruction
    • Acute from stone, bladder retention

Other important information for referring practitioners

Medical management

  • Restore BP if evidence of hypovolaemia using IV fluids
    • This should not delay urgent transfer to DEM
  • Arrange urgent transfer to DEM

Referral requirements

A referral may be rejected without the following information.

  • Presence of any Red Flags
  • Time line of symptoms
  • Medication list and allergies
  • Co-morbid conditions
  • Relevant examination findings
    • BP
    • Any evidence of infection
  • Investigations
    • Urine stick testing results
    • Send urine sample with patient if available

Additional referral information (useful for processing the referral)

  • Include last FBC, E/LFTs if available to use as baseline
  • Renal Ultrasound if available

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander
  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary
  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Send referral

Hotline: 1300 364 938

Fax: 1300 364 952

Electronic: eReferral system

Mail: Metro North Central Patient Intake
Aspley Community Centre
776  Zillmere Road

Health pathways

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