The Prevalence of Chronic Kidney Disease Requiring Nephrological Referral in Patients with Non-Visible Haematuria

Abstract

Objective:

To quantify the proportion of patients attending for urological investigation of non-visible haematuria who meet criteria for referral to specialist renal services under current UK guidelines.

Patients and methods:

Data were collected from 377 consecutive patients attending a dedicated non-visible haematuria clinic. Details were recorded for clinic outcomes and indicators of chronic kidney disease (eGFR, dipstick proteinuria, protein:creatinine ratio). The proportion of patients meeting referral criteria was calculated, including the increase in service need and costs.

Results:

8.7% of patients had a positive urological diagnosis, with 2.7% having malignancies. 20.7% of patients had CKD stage 3 on the basis of their eGFR readings. 16.7% of patients had dipstick proteinuria, but only 4.4% had a raised protein:creatinine ratio. Overall, up to 22% of patients met current criteria for referral to nephrology, although this varied according to guideline. At this level, it equates to a potential increase of 20–30% in new patient referrals.

Conclusion:

Features of CKD are common in patients undergoing investigation for non-visible haematuria, with high numbers meeting current UK criteria for referral to nephrology. Appropriate investigation of these risk factors should form an integral part of the haematuria clinic.