New Jersey's Experience: Mandatory Estimated Glomerular Filtration Rate Reporting

[摘要] The passage of legislation in New Jersey mandating the calculation and reporting by clinical laboratories of the estimated glomerular filtration rate whenever a serum creatinine test is performed resulted in a flurry of activity by laboratories to bring their facilities into compliance. After guidance provided by the Department of Health and Senior Services in November 2005 regarding legislative intent, New Jersey's clinical laboratories, including more than 80 acute care hospital laboratories, successfully implemented estimated glomerular filtration rate reporting by July 2006. This reporting, however, was not achieved without controversy and logistical barriers. Despite these issues, the initial feedback from physicians in response to receiving estimated glomerular filtration rate values on test reports as mandated by state law has been largely favorable. With more than 3.5 million estimated glomerular filtration rate values reported to the department by a sampling of large independent (n = 3), physician office (n = 4), and hospital (n = 11) laboratories, average estimated glomerular filtration rate values were as follows: 79% of physician office and independent laboratory estimated glomerular filtration rate values were ≥60 ml/min per 1.73 m2, and 2% were <30 ml/min per 1.73 m2; by comparison, 66 and 11% of hospital values were ≥60 and <30 ml/min per 1.73 m2, respectively. Additional studies are necessary to determine whether the intent of the legislation to “aid health professionals in the early diagnosis of kidney disease,” thereby resulting in improved treatment outcomes, is achieved.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome