When to refer

• Haematuria is an indication of active disease and such patients should be referred immediately for investigation. Oliguria makes this even more urgent.

• Any patient with impaired renal function should be investigated and a management plan formulated.

• Patients with creatinine clearance of less than 20 mL/min (plasma creatinine > 0.05 mmol/L) are best followed in a renal clinic. Diabetic patients warrant specialist referral when the plasma creatinine is at 0.2 mmol/L. 3

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