Go to whole of WA Government Search
Disorders of Fluid Balance Diabetes Insipidus Referral Access Criteria

Disorders of Fluid Balance Diabetes Insipidus Referral Access Criteria

Referrers should use this page when referring patients to public paediatric endocrinology and diabetes outpatient services for disorders of fluid balance (diabetes insipidus). This RAC is applicable to referrals for patients aged <16 years only.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Polyuria or polydipsia with altered sodium levels and with normal blood glucose levels and normal calcium levels
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate paediatric endocrinology assessment (seen within 7 days):
  • Nil

To contact the relevant service, see HealthPathways: Acute Paediatric Assessment (external site)
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Polyuria
  • Nocturia or new onset nocturnal enuresis
  • Polydipsia
  • Alterations in sodium levels
  • Headaches
  • Skin changes
  • Irritability in infants
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History
  • Relevant history, onset, duration and severity of symptoms
  • Current medication list, including any relevant medication use that may influence fluid balance
  • Any known allergies
  • Estimated fluid intake and output
  • Familial history of diabetes insipidus
Examination
  • Nil
Investigations
  • U&Es
  • BGL (to exclude diabetes mellitus)
  • Ca
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • FBC
  • Urinalysis
  • Urine dipstick: specific gravity and glucose
  • Paired urine and serum osmolality, ideally in the morning
  • USS renal
  • Cerebral MRI with pituitary view
Indicative triage category

Category 1

Appointment within 30 days
  • Follow up clinic from emergency presentation
  • Non-acute hypo- or hypernatraemia
  • Significant changes in fluid balance

Category 2

Appointment within 90 days
  • No defined category 2 criteria

Category 3

Appointment within 365 days
  • No defined category 3 criteria
Exclusions
  • Polyuria and polydipsia with normal serum sodium and urine osmolality suggestive of concentrated urine
Useful information
  • See Australia and New Zealand Society for Endocrinology and Diabetes for clinical resources (external site)
Last reviewed: 18-03-2024
wa.gov.au