APPROPRIATENESS OF NEPHROLOGY REFERRALS IN REGIONAL AUSTRALIA: IMPLICATIONS FOR A SPECIALIST SERVICE

J WRIGHT1, R THWAITES2, K GLENISTER1, D TERRY1

1Department of Rural Health, University of Melbourne, Shepparton, VIC; 2Rural Clinical School, University of Melbourne, Shepparton, VIC

Aim: A retrospective study, examining referrals to a regional nephrology service from 2013-2015, to establish whether referrals to a regional nephrology service met with Australian referral guidelines

Background: Regional nephrology outpatient services have limited resources. It is important that such resources are utilised efficiently to see appropriate patients in a timely manner.

Methods: All referrals to the nephrology service for chronic kidney disease were included in the study. Of a total 659 referrals, 582 were included in the study. The remainder were excluded if they did not attend the appointment, if they had a known renal disorder, or if they were referred for consideration of renal transplant donation. Data available from the referral letter, and renal function tests at the initial clinic visit were examined to determine whether data included in the referral letters met referral guidelines, and whether, when taking into account renal functional tests from the initial clinic visit, referral guidelines were met.

Results: Of 582 referrals included in the study, 253 (43.5%) met referral guidelines. After consideration of renal functional tests performed at the initial consultation, 335 (57.6%) met referral guidelines. With regard to data provided in referral letters, estimated glomerular filtration rate was included in 435 (74.7%), more than one eGFR result in 298 (51.2%), renal imaging in 201 (34.5%), blood pressure in 100 (17.2%), urinalysis for albuminuria/proteinuria in 223 (38.3%), urinary red cells in 70 (11.9%) of cases.

Conclusions: The majority of nephrology referrals to a regional Australian service did not meet referral guidelines. This has significant implications for a regional nephrology service due to workforce pressures. It is imperative that knowledge and implementation of nephrology referral guidelines are increased.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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