Urinary Tract Infection - Royal Children's Hospital

Initial work-up and pre-referral guidelines for paediatrics

NEPHROLOGY

Haematuria

Definition:
Microscopic haematuria: The presence of >14 RBC/micrometres on urine microscopy
Macroscopic or gross haematuria: Darkening of urine visible to the naked eye

Referral when Initial Work-Up Data needed

• Family history of renal failure or • Perform at least 2 consecutive urine Bring to appointment:
deafness dipsticks or urinalysis 1-2 days apart to
confirm the diagnosis. • Growth records
• Microscopic haematuria in multiple
family members • Check blood pressure and growth. • Copies of all laboratory tests
performed
• Recurrent episodes of painless gross Urine Tests:
haematuria • Urinalysis with microscopy (clean catch • Copies or originals of all
radiological studies with
Urgent phone consultation or urine) written reports
immediate referral to paediatric
nephrology is strongly recommended in the • Urine culture
presence of any of the following:
• Urine protein and creatinine ratio
• Constitutional symptoms like weight
loss, fever, arthralgias or rash • Urine calcium to urine creatinine ratio
(N=<0.7mmol/mmol)
• Evidence of poor growth
• Urine dipstick on family members
• Elevated blood pressure
• Serum coags if macroscopic haematuria.

REFERRAL FORM and PARENT HANDOUT also available on www.rch.org.au/kidsconnect

Clinical advice Tel (03) 9345 7060 – 1: ED or call Nephrology Dept (03) 9345-5054/5072 - ask for Consultant or Registrar on-call

Book appointment www.rch.org.au/kidsconnect/outpatients.cfm fax referral direct to (03) 9345-5611 / call dept (03) 9345-5054/5072

Kids Connect Primary Care Liaison www.rch.org.au/kidsconnect /tel (03) 9345 4645 - please give feedback on guidelines
Kids Health Info Parent information www.rch.org.au/kidsinfo See final page references, ©, disclaimer & further contact details

Initial work-up and pre-referral guidelines for paediatrics

NEPHROLOGY

• Presence of oedema Serum tests: REFERRAL FORM
• Elevated serum creatinine • Creatinine/U&Es Download (Word)
• Presence of RBC casts upon urine • Electrolytes
• Full Blood Count PARENT HANDOUT
microscopy Download (pdf)
• Abnormal renal ultrasound
• Haematuria with associated proteinuria
• Decreased urine output

REFERRAL FORM and PARENT HANDOUT also available on www.rch.org.au/kidsconnect

Clinical advice Tel (03) 9345 7060 – 1: ED or call Nephrology Dept (03) 9345-5054/5072 - ask for Consultant or Registrar on-call

Book appointment www.rch.org.au/kidsconnect/outpatients.cfm fax referral direct to (03) 9345-5611 / call dept (03) 9345-5054/5072

Kids Connect Primary Care Liaison www.rch.org.au/kidsconnect /tel (03) 9345 4645 - please give feedback on guidelines
Kids Health Info Parent information www.rch.org.au/kidsinfo See final page references, ©, disclaimer & further contact details

Initial work-up and pre-referral guidelines for paediatrics

NEPHROLOGY

CONTACT INFORMATION (03) 9345 5054/5072 Copyright and Disclaimer
(03) 9345 7060
Department of Nephrology Press: Copyright 2006, Royal Children’s Hospital (RCH),
Quick Access RCH Number 1 Victoria, Australia. Adapted with permission from
For the following departments: 2 Children’s Hospital and Regional Medical Center, Seattle,
Emergency Department - clinical advice 3 WA, USA.
Outpatient appointments - bookings 4
Pathology - results The RCH and Children’s Hospital and Regional Medical
Radiology - results 5 Center are not responsible in any way for application of
Main RCH switchboard – the procedures or guidelines to patient care at your
facility. They are guidelines only and your professional
ask for appropriate specialist on-call judgment must always prevail. Guidelines may not be
reproduced without permission.
Rural doctors only, OPD bookings (03) 9345 6789 RCH Kids Connect – Primary Care Liaison
www.rch.org.au/kidsconnect
Admission enquiries (03) 9345 6172
Admission enquiries (03) 9345 6477 These guidelines were developed by specialists at the
ED admission enquiries (03) 9345 5522 Royal Children’s Hospital and reviewed by a working
via switchboard group of metropolitan and rural general practitioners in
Admission enquiries after hours Victoria.

RCH Drug Info Line (03) 9345 5208 Last reviewed
January 2007
Seriously unwell child (03) 9345 7007
For the following departments: Press: References
Paediatric Emergency Transfer 1 Paediatric Handbook (2003)
Newborn Emergency Transfer 2 Renal conditions and enuresis, Chapter 32 (pp546-566)
RCH Emergency Department 3 Colin Jones and Annie Moulden
Monash Medical Centre ED 4 Seventh Edition, Blackwell Publishing
By the staff of the Royal Children’s Hospital, Melbourne,
Australia.

REFERRAL FORM and PARENT HANDOUT also available on www.rch.org.au/kidsconnect

Clinical advice Tel (03) 9345 7060 – 1: ED or call Nephrology Dept (03) 9345-5054/5072 - ask for Consultant or Registrar on-call

Book appointment www.rch.org.au/kidsconnect/outpatients.cfm fax referral direct to (03) 9345-5611 / call dept (03) 9345-5054/5072

Kids Connect Primary Care Liaison www.rch.org.au/kidsconnect /tel (03) 9345 4645 - please give feedback on guidelines
Kids Health Info Parent information www.rch.org.au/kidsinfo See final page references, ©, disclaimer & further contact details