Prevalence of Estimated GFR Reporting Among US Clinical Laboratories
Received 27 December 2007; accepted 9 May 2008. published online 04 August 2008.
Refers to article:
Reporting Estimated GFR: A Laboratory Perspective
W. Greg Miller
American Journal of Kidney Diseases
October 2008 (Vol. 52, Issue 4, Pages 645-648) Full Text |
Full-Text PDF (73 KB)
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 m2” 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.
1National Kidney Disease Education Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
Address correspondence to Andrew S. Narva, MD, Director, National Kidney Disease Education Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Two Democracy Plaza, Rm 645, 6707 Democracy Blvd, Bethesda, MD 20892-0001
ABSTRACT