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Streatham & Clapham Health Renal Outreach Clinic Dr Debasish Banerjee, Consultant Nephrologist, St. Georges Hospital Dr Azhar Ala, General Practitioner,Wandsworth.

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Presentation on theme: "Streatham & Clapham Health Renal Outreach Clinic Dr Debasish Banerjee, Consultant Nephrologist, St. Georges Hospital Dr Azhar Ala, General Practitioner,Wandsworth."— Presentation transcript:

1 Streatham & Clapham Health Renal Outreach Clinic Dr Debasish Banerjee, Consultant Nephrologist, St. Georges Hospital Dr Azhar Ala, General Practitioner,Wandsworth Road Honorary Clinician, Dept. Renal Medicine, St. Georges Hospital

2 Who to refer STAGE 3 CKD (eGFR 30-59) – Progressive fall in GFR (>4ml/min per year) – Microscopic haematuria – Proteinuria, if prot/creat ratio >100mg/mmol – Unexplained anaemia (Hb <110g/l), abnormal potassium, calcium or phosphate – Suspected systemic illness (e.g. SLE) – Uncontrolled BP (>150/90 on 3 agents) STAGE 4 CKD (eGFR 15-29) Not achieving target BP control ie 100mg/mmol

3 HOW TO REFER Performa Fax through to secretary AT ST.GEORGES Contact back if need more information Able to give clinic letter to patient at end of appointment AND FAX TO GP

4 Valuable information for referral Brief history - particularly noting urinary symptoms, previous blood pressures, urine testing. Medications Urine dipstick - and protein/creatinine ratio if +. Blood tests - FBC, urea and electrolytes, calcium, albumin, phosphate, cholesterol, HbA1c if diabetic. Previous tests of renal function with dates, back to normal renal function if possible Imaging - results of renal imaging if undertaken

5 REQUIREMENT FOR FOLLOWUP Blood tests Repeat urine quantification if needed Ultrasound if needed

6 Evaluation Survey of patients and practices – Patient satisfaction- DOCTOR,INFORMATION – Referring physician satisfaction – Rate of GFR decline – BP control- Initial visit and follow up Conversion of referrals to secondary care Start JAN 2008 GRACEFIELD GARDENS 3 MONTH PILOT INITIALLY


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