1. Community Kidney e-clinic referral
Who to refer?
Every one you would otherwise refer to renal OPD
NICE guidance 2014
eGFR less than 30ml/min – with or without diabetes
ACR 30mg + with haematuria
ACR 70mg/ml+ (unless diabetes AND appropriately treated)
Sustained decrease in eGFR of 15ml in past year – or 25% decrease in eGFR
Poorly controlled hypertension (with 4 medications)
Known or suspected rare or genetic causes of CKD
Suspected renal artery stenosis
Who to refer

2. Community Kidney E-clinic referral
How to refer:
Discuss referral with patient, ask permission for community renal consultant to view GP record.
Click the sharing button in EMIS Web to record patient consent
Open the CKD template, decide whether further tests needed, record data sharing and code clinic referral
Write in the narrative record what you want from the renal consultant.
In C&B choose ‘City and Hackney Community Kidney E-clinic’
How to refer

3. Community Kidney E-clinic referral
The renal consultant will:
Review notes, CKD template and investigations
Document advice and management in the renal community clinic record on EMIS Web
Send the discharge letter to the practice generic nhs.net a week after the e-appointment slot. You can also view it on the Shared Care Record.
Renal consultant will