Literature DB >> 18676076

Prevalence of estimated GFR reporting among US clinical laboratories.

Nancy A Accetta1, Elisa H Gladstone, Charles DiSogra, Elizabeth C Wright, Michael Briggs, Andrew S Narva.   

Abstract

BACKGROUND: Routine laboratory reporting of estimated glomerular filtration rate (eGFR) may help clinicians detect kidney disease. The current national prevalence of eGFR reporting in clinical laboratories is unknown; thus, the extent of the situation of laboratories not routinely reporting eGFR with serum creatinine results is not quantified.
DESIGN: Observational analysis.
SETTING: National Kidney Disease Education Program survey of clinical laboratories conducted in 2006 to 2007 by mail, web, and telephone follow-up. PARTICIPANTS: A national random sample, 6,350 clinical laboratories, drawn from the Federal Clinical Laboratory Improvement Amendments database and stratified by 6 major laboratory types/groupings. PREDICTORS: Laboratory reports serum creatinine results. OUTCOMES: Reporting eGFR values with serum creatinine results. MEASUREMENTS: Percentage of laboratories reporting eGFR along with reporting serum creatinine values, reporting protocol, eGFR formula used, and style of reporting cutoff values.
RESULTS: Of laboratories reporting serum creatinine values, 38.4% report eGFR (physician offices, 25.8%; hospitals, 43.6%; independents, 38.9%; community clinics, 47.2%; health fair/insurance/public health, 45.5%; and others, 43.2%). Physician office laboratories have a reporting prevalence lower than other laboratory types (P < 0.001). Of laboratories reporting eGFR, 66.7% do so routinely with all adult serum creatinine determinations; 71.6% use the 4-variable Modification of Diet in Renal Disease Study equation; and 45.3% use the ">60 mL/min/1.73 m(2)" reporting convention. Independent laboratories are least likely to routinely report eGFR (50.6%; P < 0.05) and most likely to report only when specifically requested (45.4%; P < 0.05). High-volume laboratories across all strata are more likely to report eGFR (P < 0.001). LIMITATIONS: Self-reporting by laboratories, federal database did not have names of laboratory directors/managers (intended respondents), assumed accuracy of federal database for sample purposes.
CONCLUSIONS: Routine eGFR reporting with serum creatinine values is not yet universal, and laboratories vary in their reporting practices.

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Year:  2008        PMID: 18676076      PMCID: PMC2572813          DOI: 10.1053/j.ajkd.2008.05.023

Source DB:  PubMed          Journal:  Am J Kidney Dis        ISSN: 0272-6386            Impact factor:   8.860


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