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KidneyWise
KidneyWise Toolkit Referral Form

Monitor Patient

Since the person’s last visit, are any of the following true?

  • eGFR < 30 or ACR > 60, or
  • Rapid deterioration in kidney function: eGFR < 45 and decline of > 5 ml/min within 6 months in absence of self-limited illness; eGFR must be repeated in 2-4 weeks to confirm persistent decline, or
  • 5-year Kidney Failure Risk Equation (KFRE) ≥ 5% (Go to a KFRE calculatorOpens in a new window; please refer to evidence summary for details on KFRE criterion), or
  • Inability to achieve blood pressure (BP) targets, or
  • Significant electrolyte disorder, or
  • RBC casts or hematuria (> 20 RBC/hpf) suggestive of glomerulonephritis/renal vasculitis
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