engleski

Standardization of laboratory diagnostics of chronic kidney disease in Croatia

In February 2014 a new 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) was established. The JWG comprised 3 members from CSMBLM and 2 members from CCMB. The aim of the new established JWG was to provide easily applicable first Croatian recommendations for laboratory diagnostics of CKD. At the initial meeting of the JWG a detailed workflow was developed which comprised various steps. To assess the current state of laboratory diagnostics of CKD in Croatian medical biochemistry laboratories, the initial assignement included performing a survey among laboratories. The survey was mainly focused on the two key prerequisites for CKD screening: automatic reporting of eGFR and albuminuria and/or proteinuria assessment. An on-line survey was conducted from March till May 2014. The survey results showed large heterogeneity in this area of laboratory medicine among Croatian laboratories regarding measuring methods, reporting units and reference intervals (cut-off values), both for creatinine and urine albumin or protein, thus supporting the need for national recommendations. The initial draft of the first national recommendations for laboratory diagnostics of CKD in Croatia was finished in January 2015. The national recommendations are mainly based on the KDIGO 2012 recommendations, however, novel literature findings are also incorporated. Considering the results obtained via conducted survey, our main goal was to provide recommendations that can be easily applied in every medical biochemistry laboratory in Croatia. The text of the national recommendations is organized to identify critical points in four major laboratory tests used in basic laboratory diagnostics of CKD. The draft of the recommendations was sent to numerous national and international experts for their comments. The manuscript was also made available for public consultation. All comments were carefully considered and incorporated into the final version of the recommendations. In 2017 the recommendations were published in the peer-reviewed scientific Journal in English language, and translated to Croatian. These national recommendations, based on the relevant 2012 KDIGO Guideline, represent the first step in accomplishing the goal of standardization and harmonization in this area of laboratory medicine. The subsequent actions of the JWG were to provide extensive support to implementation process of the national recommendations. Every member of the JWG activelly participated in the implementation process. We inteded to provide relevant information to every medical biochemist in our geografically diverse country. To facilitate implementation of national recommendations the members of a national JWG gave a series of lectures entitled: „The role of laboratory testing in detection and classificaton of chronic kidney disease: national recommendations”. Finally, to ensure the objective measurement of the success rate of the implementation process, our subsequent actions included repeating a slightly modified survey that was initially conducted in 2014. The second survey was conducted from November till December 2017. The aim of this lecture is to present all activities of our JWG related to the standardization of laboratory diagnostics of CKD in Croatia, including the preliminary results of the second survey.

CKD, standardization, harmonization, recommendations, Croatia

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