Introduction
This guideline relates to duplex kidney in paediatric patients.
A duplex kidney is a common (1 in 100) variant of kidney anatomy.
Uncomplicated duplex kidneys (no urinary tract dilatation, normal
parenchymal appearances, normal blood pressure, no urinary tract infections) do
not require specialist nephrology assessment or follow up, and can be
managed without specialist input.
When to refer
- Patients <18 years
- Recurrent culture-positive urinary tract
infection
- Elevated blood pressure (manual measurements
consistently >95th centile)
- Elevated urine protein (repeated early
morning samples during good health greater than 2x upper limit of normal)
- Urinary tract dilation affecting the renal
parenchyma.
Wait time for appointments
Specialist Clinic wait times
(Please note, non-urgent referrals for patients over the age of 16 may
be declined if it is likely they will not be seen before their 18th
birthday.)
Services available closer to home
Alternative paediatric nephrology services available in Victoria:
- Monash Children's Hospital
Referral criteria/required information
Starred items (*) are
mandatory.
- *Details of
clinical concern requiring nephrologist input, including duration of symptoms
and details of all treatments offered to date
- *Current height
and weight
- *Observations
including BP
- Blood tests (if performed):
- Electrolytes, urea, creatinine (EUC)
- Calcium, magnesium, phosphate, albumin
- Urine tests (if performed):
- Urine microscopy
- Early morning urine total protein: creatinine
ratio (NOT an albumin:creatinine ratio)
- *Renal ultrasound
report
Failure to include reports of pathology and
radiology investigations will result in the referral being returned to the referring
doctor for resubmission. A written summary of the renal ultrasound report will
not be accepted.
Referrals from public hospitals MUST INCLUDE the name and
contact details of a consultant supervising paediatrician/neonatologist and GP.
The patient remains in the care of the referrer until such time that they
are seen in the Kidney Clinic.
How to refer
Specialist Clinic referral
Please complete the above and submit via:
Suggested pre-referral management
- Duplex
kidney is a common and most often uncomplicated variant of normal kidney
anatomy.
- Abdominal
pain should not be attributed to an uncomplicated duplex kidney in the absence
of other symptoms consisted with a kidney condition.
- Infants
with an uncomplicated duplex kidney identified on an ultrasound performed less
than 2 weeks of age, should have a repeat ultrasound performed around 3 months
of age to confirm normal appearances.
- Dilatation
within a duplex kidney can be managed in accordance with urinary tract dilation
(UTD) guidelines.
Information for families
Your child’s referral will be triaged based on the information received
in the referral. Your referrer will continue to monitor and manage your child’s
care prior to and after your consultation. If there is a change in the
clinical situation, a new referral explaining the need for re-triage of the referral
is required. If you are seen elsewhere, please cancel your appointment with our service
so that we can provide service to another child on our wait list.
Resources and links
Acknowledgements
The development of this guideline was coordinated by the Department
of Nephrology. Guideline reviewed in June 2026.