Guide to funded genomic tests for nephrologists

Looking for somewhere to start? You’re in the right spot

This is a step-by-step guide for nephrologists ordering Medicare funded genomic tests for their patients.

Eligibility

Should I consider genomic testing for my patient?

These tools use a simple traffic-light system help you identify patients that may be suitable for genomic testing within your nephrology clinic, and patients that should be referred for genetics input prior to initiating testing.

Traffic light tool for adult patients

Traffic light tool for paediatrics

What are the risk factors for genetic kidney disease?

Risk factors for genetic kidney disease include one or more of the following:

  • Young age (<35 years) of presentation
  • Family history of kidney disease​
  • Parental consanguinity​
  • Persistent haematuria >6months, no obvious cause​1
  • CKD with bland urine (if other causes excluded, e.g. hypertension)​
  • ESKD <50 with unclear aetiology2

1. If a genomic diagnosis would negate the need for a renal biopsy, consider genomic testing prior to biopsy in diagnostic workup (Jayasinghe et al., 2021).

2. Based on the HIDDEN study (manuscript under review) the diagnostic yield was 10% in those without family history and 24% in those with a family history of kidney disease. Manuscript under review (Soraru et al., 2022). 

Ordering

What test should I order?

This decision aid can help you decide which test is most appropriate for your patient.

This resource refers to the Multidisciplinary Team (MDT) and Genetic Counsellor Support Line. Here’s how to access these services.

How do I order a test?

This checklist has the key steps for ordering a Medicare-funded genomic test.

Use these order forms to request a Medicare-funded genomic test.

Consent and insurance

How do I explain the test and informed consent to my patients?

Informed consent

Consent for genetic and genomic testing follows the same principles of consent that govern all clinical practice in Australia. These resources from Australian Genomics can support an informed consent discussion.

This video is for patients and their families who have had a genomic test through the Kidney Clinic. It will recap the information provided in clinic about the genomic test.

Insurance

This fact sheet explains how genetic and genomic testing may impact a patient's insurance policies.

Many life insurance companies have agreed to a moratorium that limits the use of genetic test results when assessing life insurance applications. Here are the key facts.

Results

How do I explain genomic results to patients?

This Visual Genomics Report will help you understand the contents of a genomic report, and explain relevant sections of the report to patients.

Please contact your local multidisciplinary team to discuss results prior to patient contact. You can also contact the Genetic Counsellor support line.

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