Kidney+Disease+Clinic

"Diablo Renal" Clinic
In Pittsburg, the third Wednesday AM of each month Patients with a GFR < 10 - 15 should be referred instead for evaluation and preparation for **hemodialysis**. Patients in West County need to referred to "East Bay Nephrology" while patients in Central and East County should be referred to Mt. Diablo Nephrology (in Concord).
 * WHERE:** Martinez Specialty Care outpatient clinic and Pittsburg
 * WHEN**: In Martinez, the first Wednesday AM of each month
 * WHY**: There is a burgeoning epidemic of chronic renal disease, especially in Contra Costa County. The first step toward battling this epidemic is the recognition that renal disease is present followed by the accurate diagnosis of the etiology. There are subsequently many things that can be done to mitigate and delay the progression of renal disease. The objective of this clinic is to help recognize, diagnose and treat chronic renal failure. Treatment would include assistance with management of anemia, secondary hyperparathyroidism, resistant hypertension, proteinuria, electrolyte abnormalities, and preparation for hemodialysis. **We will not offer hemodialysis** however. Another aspect of the clinic will be patient education about their renal disease.
 * WHO**: All patients with a GFR <60 (but see below) and/or GFR>60 but with persistent unexplained proteinuria or casts and red cells are invited to be referred to this consult clinic. Most patients will need one or a few visits only and then will be referred back to their primary care providers. In some cases, a patient will be referred to the **Renal** clinic if they need a renal biopsy; this is the primary objective of the Renal clinic.

Other labs to consider include chronic hepatitis panel, SPEP/UPEP, and ANA depending on other risk factors
 * HOW**: Put "Diablo Renal Clinic" on the MR-191. This is a chart check that will be reviewed by Dr. Gabriela Sullivan.
 * BY WHOM**: Providers in the clinic include: a nephrologist from Diablo Nephrology, Dr. Oliver Graham and Dr. Gabriela Sullivan
 * RECOMMENDED TESTS PRE-VISIT:** All patients should have:
 * UA
 * Spot urine protein
 * CBC
 * Lytes, BUN/Creatinine
 * Calcium + Phosphate
 * Renal ultrasound