Direct access ultrasound referrals

Renal direct access ultrasound pathway

For direct access referrals, please use the renal ultrasound referral form which is available for you to complete electronically on your practice management system.

Urgent pathway

Patients presenting with accelerated progression of CKD or a decrease in eGFR can be imaged urgently.

This cohort of patients must meet one of the following criteria:

• Accelerated progression of CKD (eGFR <30ml/min and rapid >25% decrease in renal function and change in CKD category in 12 months  
• Sustained decrease in eGFR >15ml/min/1.73m² or more per year

Routine pathway

Patients must meet at least one of the following criteria:

• First renal imaging in a patient with eGFR <30ml/min/1.73m²
• Visible or persistent invisible haematuria in a low cancer risk group (<45 years or >60 with recurrent or persistent unexplained urinary tract infection)
• Family history of polycystic kidney disease age >20 years

Pelvis direct access ultrasound pathway

Patients who present with a strong suggestion of ovarian cancer with raised CA125 can be imaged urgently.

Please use the urgent pelvic ultrasound (ovarian premenopausal) referral form which is available on your practice management system for you to complete electronically.

Stringent referral criteria must be met for this cohort of patients:

• A face to face consultation has taken place to exclude abdominal/pelvic mass and ascites
• Suspicion of malignancy with ovarian cancer symptoms as per NICE guideline NG12
• CA125 Level is between 35-70 IU/ml
• Confirmation they are premenopausal

If the patient does not fulfil the above criteria, but you have a strong suspicion of malignancy, please use the 2WW non-specific symptom (NSS) referral form.