Diabetic kidney disease

Red flags

Consider urgent referral for patients with the following

  • Sudden rapid deterioration of renal function
  • Haematuria with renal function deterioration
  • Uncontrolled BP with proteinuria
  • Hyperosmolar diabetic state

Other important information for referring practitioners

Lifestyle changes

  • Encourage healthy diabetic diet and activity
  • Encourage self- monitoring of fluid balance with daily weighs

Medical management

  • Control BP
  • Maintain tight control of diabetes
  • Monitor for side effects from drugs with adverse renal side effects
    • Avoid NSAID use
    • Care using metformin

Referral requirements

A referral may be rejected without the following information.

  • Reason for referral
  • Presence of any Red Flags
  • Timeline of diabetes
    • List other co-existing diabetic complications
  • Co-Morbidities (e.g. IHD, obesity, hypercholesterolaemia, hypertension etc)
  • Current Medication List and allergies
  • Relevant examination findings
    • BP, weight, BMI
    • Presence of oedema
  • Investigations
    • FBC, E/LFTs with eGFR,  HBA1c
    • If anaemic include iron studies, B12 and folate, CRP and PTH
    • MSU microscopy for RBC with morphology, casts
    • Random urinary albumin/creatinine ratio

Additional referral information (useful for processing the referral)

  • 24hr urinary protein
  • Renal ultrasound
  • Letters containing opinion or comment from any other health workers involved in diabetic care e.g. diabetic educators, dieticians, endocrinologists etc.

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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