Renal Consult 🧪
Guide for renal/nephrology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: full name, date of birth, location and MRN; note that admission may not be for a renal reason
- Reason for renal input (e.g. AKI, electrolyte disturbance, suspected GN, dialysis access)
- Past Medical History: CKD, HTN, diabetes, autoimmune disease, transplant, urological surgeries
- Medication history – especially nephrotoxics (NSAIDs, ACEi, ARBs, diuretics), immunosuppressants
- Fluid balance: inputs/outputs, daily weights, urine colour/volume
- Observations: BP, trends in vitals, fluid status exam
- Relevant bloods: U&E, creatinine trend, eGFR, bicarbonate, Ca/Mg/PO₄, FBC, CRP
- Urine dip and microscopy (if done)
- Any imaging done (e.g. renal tract ultrasound) or required
🔎 Investigations to Know
- U&E trend — including baseline creatinine
- Urine dipstick results and microscopy if available
- Renal ultrasound (if AKI or obstruction suspected)
- Daily weights and fluid balance charts
- Relevant autoimmune or vasculitis screen (e.g. ANCA, ANA)
📞 Example Script
- Hi, this is [Your Name], the intern from the [Team Name]. I'm calling to request a renal consult for a [Age] year-old [M/F] patient, admitted for [reason for admission], but with a renal issue of [e.g. rising creatinine, hyperkalaemia, suspected GN].
- They have a background of [e.g. CKD stage 3, diabetes, HTN]. Their creatinine has risen from [baseline] to [current], and UO is [volume] over 24h.
- We’re looking for your input regarding [diagnosis / further investigation / dialysis need]. Let me know if there's anything you'd like arranged beforehand.
📝 Tips
- Be clear if this is a new AKI, worsening CKD, or other issue
- Check medication chart for nephrotoxins and hold if needed
- Know the plan for IV fluids or electrolyte correction
- Prepare relevant bloods and scans ahead if possible