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Table 3 Recommended timeframe for nephrology assessment

From: The British Columbia Nephrologists’ Access Study (BCNAS) – a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations

Priority

Nephrology conditions

Wait time target (weeks)

1. Immediately threatening renal disease – Requires rapid access

Acute kidney injury, suspected vasculitis/glomerulonephritis or Nephrotic Syndrome, eFGR < 15 ml/min

<3

2. High risk renal disease – Requires expedited access to prevent adverse outcomes

Diabetic nephropathy eGFR < 45 (ACr > 30 or dipstick positive)

3-6

New onset dipstick positive proteinuria (or repeat ACRs > 30)

3-6

CKD, eGFR < 30*

3-6

Uncontrolled hypertension

3-6

3. Stable renal disease – Requires timely access

Recurrent nephrolithiasis

6-12

Isolated microscopic hematuria

6-12

CKD, eGFR 30-45

6-12

New Diagnosis PCKD, normal eGFR

6-12

Overt Diabetic nephropathy eGFR > 45

6-12

4. At risk kidneys – Limited empirical evidence that nephrology assessment mproves outcomes

CKD, eGFR 46-60

12-24

Microalbuminuria, non DM, normal eGFR

12-24

  1. ‡ Telephone or other non-traditional modalities for advice may be considered as an alternative to a full office consultation at the discretion of the nephrologist.
  2. *Median Wait Time recommended by General Practitioners fell in the < 3 wk category. In the absence of urgent features (very low GFR, rapid loss of renal function, active urine sediment, uremic symptoms, etc), such patients can safely be seen within a timeframe of 3-6 weeks.