Refer a patient to the Nephrology department

The Renal Unit provides a comprehensive diagnostic and treatment service for children with renal disorders. It is the largest renal unit in the UK. This page includes information on how to refer a patient to the Nephrology department at Great Ormond Street Hospital.Please see our admission criteria for information about the diagnoses treated by the Nephrology Department at GOSH.

For an outpatient appointment

Referrals are accepted from consultant paediatricians.

Urgent referrals can be discussed with the on-call medical team (contact renal SPR on call via switchboard 020 7405 9200) and a decision will be made as to whether to bring the patient to an urgent appointment or admit them directly.

Routine referrals may be sent by post or faxed to 020 7829 8841. Referrals for the general nephrology clinics are pooled amongst the consultant team.

Referrals are accepted from general paediatricians, from other tertiary and quaternary specialities and from paediatric nephrologists seeking a second opinion or to transfer care, particularly for renal replacement therapy for very small children, children with difficult vascular access and complex cardiac disease.

Referrals from GPs are accepted for siblings of known patients, where there is a demonstrated renal abnormality and for second opinion.

Referrals for investigation and treatment of primary enuresis or for a first urinary tract infection in the absence of structural abnormalities will not be accepted.

The following dataset is required in order for a referral to be processed efficiently:

• Patient’s name, date-of-birth, address, NHS no. GP name and address

• Contact telephone number for patient’s parents/carers

• Name and contact detail of referring Consultant

Please contact the Nephrology department directly on telephone number 020 7405 9200, bleep 0233 (0821 out of hours) if the transfer is an emergency (patients that need life or limb saving treatment at GOSH within a few hours), or urgent (patients that need transfer to GOSH but not in the emergency category).

The renal unit accepts quaternary referrals from other renal units in the UK, from around Europe under the terms of the E112/S2 scheme and from countries with which the UK has bilateral healthcare agreements. Additionally, private referrals can be accepted.

Areas of expertise include the assessment of patients for renal transplantation, especially of patient with multiple co-morbidities or complex urological disorders, and the investigation and treatment of renovascular hypertension.

Referrals for transplant assessment should be sent to Dr Lesley Rees or Dr Stephen Marks. Referrals of patients with suspected renovascular hypertension should be sent to Dr Kjell Tullus or Dr Stephen Marks.

Getting advice for patients known to GOSH

If urgent advice is required, the renal registrar on-call would be the first point of contact via switchboard on 020 7405 9200, Bleep 0233 (Bleep 0821 out of hours).

For non-urgent advice, the consultant team may be contacted via their secretaries or by post.

Individual consultants can be contacted via their personal assistants on the extensions given. The on-call consultant can be contacted via switchboard: 020 7405 9200.

• Dr Detlef Bockenhauer, Consultant
  Tubular disorders, nephrotic syndrome and transplantation
  020 7405 9200 (ext 5583)

• Dr Daljit Hothi, Consultant
  Nephrotic syndrome and home haemodialysis
  020 7405 9200 (ext 8305)

• Prof Robert Kleta, Professor and Honorary Consultant
  General nephrology and genetic diseases
  020 7405 9200 (ext 5583)

• Dr Sarah Ledermann, Associate Specialist
  Chronic kidney disease and peritoneal dialysis
  020 7405 9200 (ext 8305)

• Dr Stephen Marks, Consultant and Clinical Lead for Renal Transplantation
  Transplant, SLE, vasculitis and hypertension
  020 7405 9200 (ext 0292)

• Dr Lesley Rees, Consultant and Lead Clinician
  Chronic kidney disease, dialysis (PD and haemodialysis)
  020 7405 9200 (ext 6725)

• Dr Shroff, Consultant
  Chronic kidney disease, dialysis (PD and haemodialysis)
  020 7405 9200 (ext 0292)

• Dr Kjell Tullus, Consultant
  Hypertension, nephrotic syndrome, vasculitis and SLE
  020 7405 9200 (ext 8305)
• Dr William van’t Hoff, Consultant
  Nephrolithiasis, tubular and renal metabolic disorders
  020 7405 9200 (ext 5583)

• Dr Paul Winyard, Honorary Consultant
  Congenital malformations and antenatal diagnosis
  020 7405 9200 (ext 0292)

• Dr Aoife Waters, Locum Consultant
  020 7405 9200 (ext 8305)

• Mr Francis Calder (lead transplant surgeon)

• Mr Geoff Koffman 

• Mr John Taylor

• Mr Nizam Mamode

• Mr Martin Drage

• Mr Jonathon Olsburgh
• Mr Nicos Kessaris
• Mr Christopher Callaghan

• Eileen Brennan, Nurse Consultant

• Sister Sarah Matthews, Eagle Ward
• Sister Lucy Thoms, Eagle Ward

• Joanna Van Ree, Eagle Ward

• Liane Pilgrim, Eagle Ward

• Sr. Liz Wright, Haemodialysis

• Sr. Suzanne Bradley, Transplant 

• Sr. Maria Scanes, Transplant coordinator

• Ms Katie Knapp, Transplant coordinator

• Sr. Michelle Cantwell, Peritoneal Dialysis Nurse

• Cecilia Mcneice, Peritoneal Dialysis Nurse

• Ms Lyney Stronach, Home haemodialysis
• Ms Hazel Webb, Nephrotic syndrome

There is the full range of diagnostic tests available in the Radiology department. We also provide services of renal biopsy. We provide all services for management of renal replacement therapy including creation of fistulae, insertion of vascular access, insertion of peritoneal dialysis access and renal transplantation.

We have an in-centre Haemodialysis Unit and children are managed in the community with home haemodialysis and home peritoneal dialysis.

In the year 2009-2010, there were 561 admissions to the renal ward (excluding day case admissions to programmed investigation unit), 7061 outpatients, 35 new renal transplants, 34 patients on chronic haemodialysis and 40 patients on chronic peritoneal dialysis.

The unit comprises a 25-bed renal and dialysis ward (known as Eagle Ward) in the Morgan Stanley Clinical Building, part of the Mittal Children's Medical Centre. Day cases are also seen on the Medical Day Care and Programmed Investigations Unit.

The unit has close links with the urology ward and Urodynamics Units. As well as renal replacement therapy (RRT), the unit also covers every other aspect of nephrology with special expertise in congenital renal anomalies, nephrotic syndrome, hypertension, vasculitis, tubular, metabolic and stone disorders.

Strong working links exist with urology, radiology and pathology. In addition, there are outreach links with a large number of teaching and district general paediatric departments. Surgical care of the patients approaching the need for RRT (CKD stage 5) is provided by a team of five transplant surgeons (see below).

There are clinical nurse specialist (CNS) posts for pre-dialysis (coordinating the living and deceased donor programme) and dialysis (including peritoneal dialysis and home haemodialysis), transplant and nephrotic patients.

We also have a senior and two other renal dieticians, a senior pharmacist, clinical psychologist, consultant family therapist, nurse counsellor, social worker, teacher and two play therapists.

• Dr Lesley Rees, Lead Clinician
  Telephone number: 020 7405 9200 (ext 6725)
• Andrea Cuff, Operational Manager
  Telephone number: 020 7405 9200 (ext 5787)