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WHEN TO REFER A PATIENT TO NEPHROLOGY ASSOCIATES OF KENTUCKIANA
 

Nephrology Associates of Kentuckiana, PSC provides care for all aspects of the prevention and treatment of kidney disease. As a referring physician, you may wonder when is the right time to refer a patient to a Nephrologist. Any time you would like our help, input or advice in regard to your patient's renal health.

Below are some general guidelines to help you in making that decision as well as some helpful presentations by Dr. Danny Woo.

There are several absolute criteria. To us this means that no matter how extensive the workup and treatment are at the primary care office, these conditions will require nephrology intervention at some point:

  • All patients with calculated GFR < 60 and concomitant proteinuria, hematuria and/or pyuria.

  • All patients with GFR < 30

  • All patients with GFR < 60 and declining.

  • Diabetics with proteinuria.

  • Incidental diagnosis of polycystic kidney disease on CT, US or MRI.

  • Unexplained proteinuria quantitated greater than 500 mg/day.

  • Nephrotic syndrome (Heavy proteinuria, edema, hypoalbuminemia, and hyperlipidemia)

  • Patients with the combination of proteinuria and hematuria or pyuria (even when proteinuria is low-grade). See note below.

  • Patients who have a kidney transplant.

  • A patient expected to need dialysis.

 

There are several conditions for which you may desire having us consult, at your discretion:

  • Sudden worsening of blood pressure in a previously stable patient.

  • Severe and/or uncontrolled hypertension:
    - In a person under the age of 35
    - In a person on 3 or more antihypertensive medications
    - In a person with any degree of kidney disease

  • Medium range proteinuria (1+ or 2+)

  • Unexplained hematuria.

  • Kidney stones.

  • Diabetes mellitus with difficult to control hypertension and/or proteinuria. See Note below

  • Patients with a history of nephrectomy and/or a solitary kidney who have any degree of renal insufficiency.

  • Medullary sponge kidney.

  • Electrolyte abnormalities such as hyponatremia, hypercalcemia, acid base disturbances, and hyperkalemia, among others.

  • Recurrent flash pulmonary edema.

  • Refractory edema.

  • Pregnant women with any degree of kidney disease.

  • Low bone density or bone pain in patients with GFR < 60 cc/min - often related to metabolic bone disease.


 

Finally, 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 calculated GFR.

 

Note: patients with newly discovered proteinuria with hematuria may have underlying acute nephritis, which requires rapid work-up and treatment. Nephrology consultation should occur urgently even when creatinine/GFR appear normal.

 

Physician Presentations

 

SERVICES

Comprehensive Renal Care Clinic
Anemia Management
Hypertension Management
Plasmapheresis
Chronic Kidney Disease Education
Risk Factor Reduction
Use of Electronic Medical Record
Nutrition Renal Vitamins

OUR MISSION

Is to provide the highest quality, most comprehensive and up-to-date care for patients with kidney disease in a courteous, respectful, and timely manner.

CONTACT US

6400 Dutchmans Pkwy, Suite 250
Louisville, KY 40205
Phone: 502-587-9660
877-585-9660
Fax: 502-540-5615

Office Locations
Hospital List
Dialysis Facilities
For Referring Physicians

2011 Nephrology Associates of Kentuckiana, PSC
6400 Dutchmans Parkway  |  Louisville, KY  40205
502-587-9660  |  502-540-5615 fax

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