engleski

How well do Croatian laboratories adhere to CSMBLM-CCMB recommendations for laboratory diagnostics of chronic kidney disease

BACKGROUND: In 2015 the Joint Working Group (JWG) of Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) and Croatian Chamber of Medical Biochemists (CCMB) for laboratory diagnostics of chronic kidney disease (CKD) have demonstrated a large heterogeneity and the need for harmonization in laboratory diagnostics of CKD in Croatia. In 2017 the JWG-CKD has published the first Croatian recommendations for laboratory diagnostics of CKD. Recommendations were distributed to all CSMBLM members. We have therefore conducted a survey to i) explore how well do Croatian laboratories adhere to CSMBLM- CCMB recommendations for laboratory diagnostics of CKD, and ii) to compare the adherence with the initial assessment conducted in 2014. METHODS: An invitation to the survey was sent to all Croatian medical-biochemistry laboratories (N = 196). The questionnaire was designed in a form of 19 questions and statements, with possible multiple answers. RESULTS: The response rate was 98/196 (50.0%) with majority of answers from primary medical-biochemistry laboratories (46.4%). The predominant method for serum creatinine measurement is standardized compensated Jaffé method (79.2%). There is substantial decrease in the number of laboratories which measure creatinine with non-standardized uncompensated Jaffé method, compared with the initial assessment conducted in 2014 ; 7% vs 40%, respectively. The number of the laboratories that do not report eGFR values decreased almost by half compared to the initial 2014 data (37.6% vs 74.4%). However, compared to the 2014 initial assessment, similar number of laboratories (54/98 vs 58/80) do not measure urine albumin or protein. CONCLUSIONS: The first Croatian recommendations for laboratory testing of CKD implementation process reached its first year. The collected data show a substantial improvement in the standardization of the serum creatinine measurement, as well as in reporting of eGFR, one of the two key prerequisites for CKD screening. However, albuminuria or proteinuria assessment is still not implemented nationwide, mainly in the primary health care laboratories due to legislative reasons.

CKD, recommendations, CSMBLM, survey

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