Serum LDL Cholesterol last two years – date: LDL cholesterol: mmol/L date: LDL cholesterol: mmol/L date: LDL cholesterol: mmol/L Serum Triglycerides last two years – date: triglycerides: mmol/L date: triglycerides: mmol/L date: triglycerides: mmol/L Renal Function (Please ensure latest tests are current ie within last two months before referral) Sodium last three recorded entries – date: serum sodium: mmol/L date: serum sodium: mmol/L date: serum sodium: mmol/L Serum Potassium last three recorded entries – date: serum potassium: mmol/L date: serum potassium: mmol/L date: serum potassium: mmol/L Serum Urea last three recorded entries – date: serum urea: mmol/L date: serum urea: mmol/L date: urea: mmol/L Serum Creatinine last three recorded entries – date: serum creatinine: micromol/L date: creatinine: micromol/L date: serum creatinine: micromol/L eGFR (MDRD formula) last recorded entries – date: eGFR: ml/min/1.73m2 date: eGFR: ml/min/1.73m2 date: eGFR: ml/min/1.73m2 UACR (Urine Albumin:Creatinine Ratio) last three recorded entries – date: uACR: mg/mmol date: uACR: mg/mmol date: uACR: mg/mmol Function(Please ensure latest tests are current ie within last two months before referral) Alkaline Phosphatase) last three recorded entries – date: Alk Phos: iU/L date: Alk Phos: iU/L date: Alk Phos: iU/L
Serum LDL Cholesterol – last two years date: LDL cholesterol: mmol/L date: LDL cholesterol: mmol/L date: LDL cholesterol: mmol/L Serum Triglycerides – last two years date: triglycerides: mmol/L date: triglycerides: mmol/L date: triglycerides: mmol/L Renal Function (Please ensure latest tests are current ie within last two months before referral) Sodium – last three recorded entries date: serum sodium: mmol/L date: serum sodium: mmol/L date: serum sodium: mmol/L Serum Potassium – last three recorded entries date: serum potassium: mmol/L date: serum potassium: mmol/L date: serum potassium: mmol/L Serum Urea – last three recorded entries date: serum urea: mmol/L date: serum urea: mmol/L date: urea: mmol/L Serum Creatinine – last three recorded entries date: serum creatinine: micromol/L date: creatinine: micromol/L date: serum creatinine: micromol/L eGFR (MDRD formula) – last recorded entries date: eGFR: ml/min/1.73m2 date: eGFR: ml/min/1.73m2 date: eGFR: ml/min/1.73m2 UACR (Urine Albumin:Creatinine Ratio) – last three recorded entries date: uACR: mg/mmol date: uACR: mg/mmol date: uACR: mg/mmol Function(Please ensure latest tests are current ie within last two months before referral) Alkaline Phosphatase) – last three recorded entries date: Alk Phos: iU/L date: Alk Phos: iU/L date: Alk Phos: iU/L
Diabetes%20SPOC%20.docx