POAC Radiology — Auckland, Counties Manukau, Waitematā
CT KUB (Kidneys, Ureters & Bladder)
This page relates to adults only. Children younger than 16 years — consider paediatric assessment instead.
See the Renal Colic and Urinary Tract Stones HealthPathway and the CT KUB HealthPathway for full referral guidance.
POAC CT KUB — within 24 hours
Pyelonephritis with flank pain not improving despite 24 hours of IV antibiotics or 48 hours of oral antibiotics — consider CT KUB instead of renal ultrasound if renal colic is a differential diagnosis.
Acute referral — within 48 hours
First presentation of suspected renal colic with no red flags.
Secondary care clinician, Primary Care Radiology Liaison (PCRL), or radiologist advises a same- or next-day CT scan.
Non-acute CT KUB
If the CT KUB clinical note required is within 48 hours, this should be referred as an e-Referral to hospital radiology, Access to Diagnostics, or private medical insurance rather than via POAC.
Alternative management
Arrange an acute renal ultrasound (within 48 hours) instead of CT KUB, unless red flags require admission:
- Females aged younger than 35 years with renal colic
- Pregnant women with renal colic — consider discussing with Obstetrics
General guidance: for pregnant patients, or females younger than 35 without haematuria, fever, history of stones, or a solitary kidney, request a renal tract ultrasound instead of CT KUB.
Repeat Imaging
Community-referred radiology is not funded by Health New Zealand in these clinical scenarios. Imaging may still be clinically appropriate, and the patient may wish to consider privately funding it themselves:
- Recurrent renal colic where pain is well controlled, and the patient is younger than 50 years, has a typical renal colic presentation, has no red flags, and has had a confirmed stone on CT KUB within the last 5 years
Avoid repeated CT KUB imaging in otherwise healthy patients younger than 50 years with a known history of kidney stones. If the presentation is typical and there are no red flags, repeat imaging is not usually required.
- Consider arranging an additional plain X-ray KUB at the same time as the initial CT. Confirming the stone is visible on X-ray at presentation allows follow-up at 4 weeks with plain X-ray instead of repeat CT, if required.
Not funded under public funding
- Surveillance of asymptomatic patients with previous nephrolithiasis
- Children younger than 16 years — consider paediatric assessment instead
Renal colic red flags (referenced above)
- Creatinine greater than 160 µmol/L, or eGFR less than 45 mL/min
- Solitary kidney
- Temperature above 38°C
- Peritonitis or signs of sepsis
- Known bilateral ureteric stones
How to refer
For the full POAC radiology referral process, see poac.co.nz/radiology-referral-process.