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CPE-003 · Referral
REF-001: Nephrology referral triggers
Nephrology referral triggers. Evaluates eGFR selected below 30.
Condition
- Any of:
- eGFR selected < 30
- KFRE five year risk >= 0.03
- cause uncertain or hereditary == true
- recurrent extensive nephrolithiasis == true
- sustained eGFR fall gt 20 percent == true
- ACR ge 300 with hematuria == true
- persistent abnormal potassium == true
- persistent acidosis == true
- anemia or bone disease complication complex == true
What it reports
- Specialist referral status: recommended or urgent by trigger
- Message: Specialist kidney care referral indicated/considered according to the triggered criterion and urgency.
Evidence
- R1KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Disease: Improving Global Outcomes (KDIGO), 2024.Supports: CKD definition and chronicity CGA classification albuminuria confirmation risk prediction referral medication stewardship progression monitoring
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
CKD-FX-002
Persistent severely increased albuminuria with mildly decreased GFR
Persistent severely increased albuminuria with mildly decreased GFR
CKD-FX-007
Confirmed CKD G3bA3 with diabetes
Confirmed CKD G3bA3 with diabetes
CKD-FX-008
Active glomerular disease red flag
Active glomerular disease red flag
CKD-FX-012
Metformin contraindication threshold
Metformin contraindication threshold
CKD-FX-013
Kidney failure range does not automatically mandate dialysis
Kidney failure range does not automatically mandate dialysis
CKD-FX-014
Possible monoclonal protein-related kidney disease
Possible monoclonal protein-related kidney disease
CKD-FX-019
Possible obstructive kidney process
Possible obstructive kidney process
CKD-EX-09
eGFR fell by more than 20% between visits
Confirmed CKD with creatinine 1.2 to 1.7 mg/dL over six months.
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