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In cases where information systems cannot identify patients for whom reporting eGFR is inappropriate, it is suggested that laboratories report eGFR for all patients and allow the provider to determine the suitability of a result for a patient’s condition. Laboratories may want to restrict eGFR reporting for some patients.For example, if eGFR is reported based on the non-African American equation, a comment could state “For African Americans, multiply by 1.212, for the MDRD equation, or 1.159 for the CKD-EPI equation.”
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Comments can supplement the calculated eGFR in cases where the laboratory’s information system cannot be programmed to report estimates based on race (African American or not African American).When ethnicity is known, it is acceptable to report a single eGFR appropriate for the race. This practice allows the provider to estimate the appropriate value for the patient's ethnicity. Since a patient's race is often not available to laboratories, and because mixed ethnicity can make it difficult to classify a patient's race, a general recommendation is to report the eGFR values for both African Americans and non-African Americans (See Sample eGFR Reports).Below are considerations for addressing common issues laboratories face when reporting eGFR: The following information will help laboratories appropriately report eGFR.Ĭommon problems. Routine reporting is easier for some laboratories than it is for others. Routinely reporting eGFR with all serum creatinine determinations allows laboratories to help identify reduced kidney function for providers, thus facilitating the detection of CKD. Once guidance is adopted, we will update this content accordingly.īecause chronic kidney disease (CKD) is poorly inferred from serum creatinine alone, NIDDK strongly encourages clinical laboratories to routinely estimate and report GFR when serum creatinine is measured for patients 18 and older, when appropriate and feasible.
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“These prospective data from our completed randomized trial do not support extending albumin use for treatment of hyponatremia in decompensated cirrhosis.Recommended eGFR equations will be changing. “Targeted albumin infusions raise serum sodium in hospitalized decompensated cirrhosis patients with hyponatremia at baseline but does not improve short-term outcome compared with standard of care,” O’Brien concluded. Researchers noted no interaction between sodium category and treatment group nor renal dysfunction and death. Patients with baseline sodium levels less than 130 mmol/L (n = 206) received either 239.4 g of albumin or 123.2 g standard care randomized albumin correlated with a 1.07 mmol/L (95% CI, 1.04-2.51) increase in sodium at day 5. Researchers analyzed the interaction between targeted albumin and standard care the composite primary endpoint was new infection, kidney disfunction or death on day 3 through day 15. In an open-label, parallel-group sub study from the ATTIRE trial, 777 patients with decompensated cirrhosis with hyponatremia received targeted 20% HAS infusions to raise albumin greater than 30 g/L for 14 days. “We considered that a more appropriate comparison would include patients in albumin was prescribed for these well-established reasons to determine whether albumin infusions specifically benefit hyponatremia.” However, the comparator group received no albumin and many hospitalized decompensated cirrhosis patients expected to develop spontaneous bacterial peritonitis or renal dysfunction” Alastair O’Brien, PhD, UCL Institute for Liver and Digestive Health, said. retrospective cohort study indicated that patients treated with human albumin solution (HAS) saw greater resolution of hyponatremia. Targeted human albumin solution increased serum sodium in hospitalized patients with cirrhosis and hyponatremia, according to prospective data presented at the International Liver Congress. If you continue to have this issue please contact to Healio