Nephrology Referral Form - Rationale for Data Inclusion

The Nephrology Referral Form, developed by NKDEP, is an interactive PDF designed to help referring health professionals provide comprehensive patient information to nephrologists in a concise format. The following information provides the rationale for why this information is important.

FOR DIABETICS:

Presence or absence of diabetes is critical to establishing an etiology for kidney disease and risk for progression.  Duration of diabetes is useful for determining the likelihood that the patient’s chronic kidney disease (CKD) is caused by diabetes.

COMPLICATIONS:

Non-kidney complications can help in determining whether kidney disease is a complication of diabetes or a co-existing medical problem.  In patients with diabetes and CKD who have proteinuria and retinopathy, diabetes is the likely cause of CKD.  The absence of retinopathy or other complications increases the likelihood of a non-diabetic etiology and may indicate the need for a biopsy.

ALBUMINURIA:

A very important prognostic marker in patients with CKD.  The duration and quantity of albuminuria are critical to assessing the patient’s current status and prognosis.  Use mg albumin/g creatinine.

HEMATURIA and URINE SEDIMENT:

May indicate the presence of an inflammatory process.

eGFR:

The rate of decline in kidney function varies from patient to patient, but CKD tends to progress at a constant rate in most individuals.  Thus, the availability of serial measurements of eGFR over a long period of time provides information that can be used to educate the patient about his/her prognosis. A decrease in the rate of decline of eGFR may reflect response to therapy.

BLOOD PRESSURE:

High blood pressure, along with proteinuria (using albuminuria as the marker) and rate of loss of kidney function, is an important prognostic indicator.  Control of hypertension is also a key opportunity to reduce the rate of progression of CKD.