| Renal Medicine | Consultant | Direct Line to Secretaries |
|---|---|---|
| Monklands Hospital | Dr W. G. J. Smith | 01236 712640 |
| Monkscourt Avenue | Dr M. F. Hand | 01236 712641 |
| Airdrie | Dr I. R. Shilliday | 01236 712582 |
| ML6 0JS | Dr J. P. Traynor | 01236 713167 |
| Switchboard | 01236 748748 | |
| Fax Number | 01236 712179 |
Background
The renal unit is mostly centred at Monklands although we have some clinics at Wishaw and Hairmyres. It is likely that your patient will be reviewed at Monklands first. Background info on the renal unit is available via the FirstPort website. This also includes access to our guidelines including CKD guidelines and advice on the use of ACE inhibitors and ARBs. These are held in the Renal Documents Library on FirstPort
Referral Process
We have two categories of referral – routine and urgent. A routine patient will be seen in approximately 9 weeks. An urgent referral should be made if you think the patient may need to be admitted and we would prefer the urgent referral is coupled with a phone call at the time of referral to discuss the case.
Reasons for Referral
For outpatient review (or at least discussion) include:
- Stage 4 and 5 CKD (i.e. eGFR < 30 ml/min on two measurements three months apart)
- Significant proteinuria i.e. ACR > 70 (or > 30 if under 55 years)
- Difficult to control hypertension
- Stage 3 CKD if under 55 years old or > 10ml/min loss of renal function over a 12 month period
To make the first visit much more meaningful it would therefore be extremely useful if the following investigations could be ordered at the time of referral (unless already available):
Essential
- Renal ultrasound – (Please refer all patients unless they have had a recent scan via Clinical Radiology to HH, MDGH and WGH on SCI Gateway. Choose the option Renal Scan- referred to renal clinic)
This will then trigger an USS which will include Renal size, renal cortex, aorta and presence or absence of hydronephrosis. If hydronephrosis is found, then a bladder USS will be undertaken.
If a renal mass is found, radiology will automatically self refer for CT and access the lab browsers for the eGFR (blood for this should have been taken as part of the renal referral process). Information regarding diabetes and metformin use should be included in the referral
The initial report will be sent to primary care as if there is a mass or obstruction this should be referred through to Urology. Renal team will have direct access to the reports in clinic so do not need the reports forwarded. With a clinic waiting time of 6-8 weeks, the USS will always be done before the patient is seen in clinic
Bloods
- Renal Profile( Request RENP), CRP, FBC. ( RENP=UE (including Bic), bili, ALT, AST, ALP, GGT, Ca, Alb, PO4)
Urine
- Urine for Albumin/Creatinine Ratio (the labs accept the abbreviation ˜ACR)
Non Essential
- All ages ‘vasculitic screen’
- Rheumatoid factor (RF), anti-nuclear antibodies (ANA), ANCA and C3 C4
If over 40 years old
- Serum electropheresis and immunoglobulins (can be requested SEP and IgGs on the request form) and urine for Bence Jones protein (BJP)
On the main referral page several items are coded as mandatory fields. We hope you will be willing to put up with the minor frustration this might cause you to ensure that our mutual patient’s journey through the clinic system is made as meaningful and quick as possible.