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Nephrology

Triage criteria and referral process for physicians

Nephrology clinic referral DOES NOT APPLY to patients requiring emergency care or urological services.

Triage category Triage criteria
(not all inclusive)
Referral process
Emergent
  • eGFR < 10 mL/min/1.73m2 (new diagnosis)
  • Life threatening uremic signs & symptoms:
    • hyperkalemic > 6.5 mmol/L
    • pulmonary edema
    • pericarditis in the setting of severe renal dysfunction
  1. Immediate referral to nearest emergency department
  2. Phone referral site and ask for the nephrologist on call
  3. Fax referral after speaking with nephrologist
Urgent: Priority 1
  • eGFR < 15mL/min/1.73 m2
  • Rapid decline in eGFR > 20% over days to weeks
  • Suspected rapidly progressive glomerulonephritis
  • ACR > 220 mg/mmol (or PCR > 300 mg/mmol or 24 hour proteinuria > 3g/TV) in non-diabetic
  • Pregancy & CKD (urgent)
  1. If patient in shock, refer to emergency department
  2. Rule out urinary tract obstruction
  3. After excluding shock and GU obstruction, phone referral site and ask for the nephrologist on call
  4. Fax referral after speaking with nephrologist
Semi-Urgent: Priority 2
  • Sub acute renal dysfunction
  • Decline in eGFR > 20% over weeks to months
  • ACR > 220 mg/mmol (or PCR > 300 mg/mmol or 24 hour proteinuria > 3g/TV)
  • Pregnancy & CKD (semi-urgent)
  1. Rule out urinary tract obstruction
  2. Fax referral
Elective: Priority 3
  • eGFR < 30
  • eGFR decline over months (eGFR 30-60 AND eGFR decline > 10mL/min/1.73m2 in 1 year)
  • ACR > 60 mg/mmol in non-diabetic (PCR > 100 mg/mmol or 24 hour proteinuria > 1 g/TV)
  1. Rule out obstruction, if history of:
    • nephrolithiasis
    • BPH
    • GU strictures
    • gross hematuria
    • malignancy
    • radiation
    • GU anatomic abnormalities or
    • other risk factors for or symptoms of urinary tract obstruction
  2. Fax referral
Elective: Priority 4
  • eGFR 30-60 with slow eGFR decline over years
  • ACR > 30 mg/mmol in non-diabetic, age < 70 (PCR > 50 mg/mmol or 24 hour proteinuria > 500 mg/TV)
  • Fax referral
  • Phone consultation available
Elective: Priority 5
  • Minor abnormalities in blood, urine or radiological tests
  • Other conditions deemed elective by triage Nephrologist
  • Fax referral
  • Phone consultation available

 

Contact information

  Nephrology Office
Fax 902-473-2675
Mailing address Division of Nephrology
5820 University Avenue
Room 5077 Dickson Building
Halifax, NS B3H 1V8
Nephrologists View list of physicians
   
Forms Nephrology referral form

 

Learn more about our division
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View the Division of Nephrology