Referral to aspecialist renal service or nephrologist is recommended in the following situations:
- eGFR<30ml/min/1.73m2
- Persistent significant albuminuria (urine ACR ≥30 mg/mmol)
- A sustained decreased in eGFR of 25% or more, or a sustained decrease in eGFR of 15 ml/min/1.73m2 within 12 months
- Chronic kidney disease with hypertension that is hard to get to target despite at least three anti-hypertensive agents
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