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Routine laboratory testing in hemodialysis: how frequently is it needed?
Claudia Chidiac1, Dania Chelala2,3, Dany Nassar1
1Department of Internal Medicine, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
BMC Nephrology
|October 28, 2022
Summary
Routine laboratory tests in hemodialysis patients may be reduced without impacting care quality. Personalized testing schedules can safely lower costs, especially in resource-limited settings.
Area of Science:
- Nephrology
- Clinical Chemistry
- Healthcare Management
Background:
- Routine laboratory testing is standard for hemodialysis patients.
- Uncertainty exists regarding the impact of these tests on clinical decision-making.
Purpose of the Study:
- Quantify yearly interventions based on laboratory tests.
- Identify patient groups benefiting from adjusted laboratory testing frequency.
Main Methods:
- Multi-center retrospective study of hemodialysis patients (>1 year).
- Collected yearly average lab data (hemoglobin, URR, phosphate, etc.) and prescription changes (ESAs, IV iron, etc.).
- Used multivariate regression to identify factors associated with intervention frequency.
Main Results:
- 210 patients included; lab parameters generally within KDIGO targets.
- Median yearly interventions: 5 for ESAs, 4 for IV iron, 1 for phosphate binders.
- Higher ferritin, ESA/alfacalcidol changes, and PTH correlated with more prescription changes.
Conclusions:
- Therapeutic interventions rarely exceeded six times yearly per parameter.
- Reduced testing frequency is feasible without compromising hemodialysis patient care quality.
- Personalized testing can reduce costs, particularly in low-resource settings.
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