New Jersey's experience: mandatory estimated glomerular filtration rate reporting.

Area of Science:

• Clinical Chemistry
• Nephrology
• Health Policy

Background:

• New Jersey legislation mandated clinical laboratories to calculate and report estimated glomerular filtration rate (eGFR) with serum creatinine tests.
• Implementation followed guidance from the Department of Health and Senior Services in November 2005.
• Over 80 acute care hospital laboratories were involved in the compliance efforts.

Purpose of the Study:

• To assess the implementation and initial physician feedback on mandatory eGFR reporting in New Jersey.
• To analyze reported eGFR values from various laboratory types.
• To evaluate the potential impact on early kidney disease diagnosis.

Main Methods:

• Clinical laboratories in New Jersey implemented eGFR calculation and reporting.
• Data from over 3.5 million reported eGFR values were collected from independent, physician office, and hospital laboratories.
• eGFR values were analyzed and compared across different laboratory settings.

Main Results:

• New Jersey clinical laboratories successfully implemented eGFR reporting by July 2006, despite initial challenges.
• Physician feedback on receiving eGFR values has been largely positive.
• Analysis of reported values showed differences between laboratory types: 79% of independent/physician office eGFRs were ≥ 60 ml/min/1.73 m², compared to 66% for hospital labs. Conversely, 11% of hospital eGFRs were < 30 ml/min/1.73 m², versus 2% for independent/physician office labs.

Conclusions:

• Mandatory eGFR reporting was successfully implemented in New Jersey clinical laboratories.
• Initial physician response to eGFR reporting is favorable.
• Further research is required to determine if the legislation effectively aids in the early diagnosis of kidney disease and improves treatment outcomes.