Dear Colleagues,
I am writing for the specific information of Australian and New Zealand
list members who may be following this thread, but also for the general
information of others.
The routine reporting of an estimated GFR with every serum creatinine using
the Cockroft and Gault formula or one of the MDRD formulae appears to have
significant possible public health benefits. In order to do this well we
need to assess the effects of within and between-method differences in
creatinine measurement; standardise serum creatinine reporting; choose an
appropriate formula; decide on limitations for the use of the formula
(paediatrics, abnormal body composition etc); and develop support material
for the GPs receiving the results (with lots of older patients with low
GFRs). This list is just for starters.
In Australia and New Zealand there is a Working Party from Kidney Health
Australia, The College of Pathologists and the AACB aiming to reach a
consensus on these issues so that we can at least be doing the same things
across the countries. We aim to produce a draft guideline, have this
reviewed by the relevant parent bodies, and then promulgate to
laboratories, renal physicians and GPs.
It may be ambitious to attempt a Nation-wide response but it could be of
great benefit to our customers (doctors and patients) if we can all do the
same thing.
Regards,
Graham
Dr Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney
Ph: (02) 8382-9160
Fax: (02) 8382-2489
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