Evidence map›Paper›PMID 36303122›Full record

ArticleBMC nephrology2022

Routine laboratory testing in hemodialysis: how frequently is it needed?

Claudia Chidiac, Dania Chelala, Dany Nassar, Chadia Beaini, Hiba Azar, Serge Finianos, Celine Boueri, Jenny Hawi, Ibrahim Abdo, Mabel Aoun

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Claudia ChidiacDepartment of Internal Medicine, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Dania ChelalaNephrology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Dany NassarDepartment of Internal Medicine, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Chadia BeainiNephrology Department, Bellevue Medical Center, Mansourieh, Lebanon.
Hiba AzarNephrology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Serge FinianosNephrology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Celine BoueriNephrology Department, Saint-George Hospital, Ajaltoun, Lebanon.
Jenny HawiNephrology Department, Saint-George Hospital, Ajaltoun, Lebanon.
Ibrahim AbdoNephrology Department, Bellevue Medical Center, Mansourieh, Lebanon.
Mabel AounNephrology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. aounmabel@yahoo.fr.
Hôtel-Dieu de France · LBSaint Joseph University · LBAmerican University of Beirut Medical Center · LBSaint George Hospital · LB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHemodialysis patients are followed by routine laboratory testing. There is uncertainty whether these tests always lead to a change in decision-making. This study aims to discover the number of yearly interventions/changes in prescription based on these tests and depict the group of patients who would benefit from reduced or increased laboratory blood tests.

methodsThis is a multi-center retrospective study that included patients on hemodialysis for more than one year. Laboratory data collected included yearly average of hemoglobin, urea reduction ratio (URR), serum phosphate, calcium, potassium, parathormone (PTH), ferritin and transferrin saturation (TSAT); changes in prescription of erythropoietin-stimulating agents (ESAs), intravenous (IV) iron, alfacalcidol, phosphate binders and dialysis parameters were retrieved from medical records. A multivariate regression analysis assessed factors associated with high number of interventions.

resultsA total of 210 hemodialysis patients were included: 62.4% males, 47.1% diabetics. Their median age was 72 (62,78.5) years. Their laboratory parameters were within KDIGO targets. The median number of yearly interventions was 5 (3,7) for ESAs, 4 (2,6) for IV iron, 1 (0,2.25) for phosphate binders, 0 (0,1) for alfacalcidol. Based on the multivariate analysis, patients with higher ferritin, frequent changes in ESA, more changes in alfacalcidol and higher PTH had higher number of prescription's changes in ESA, IV iron, phosphate binders and alfacalcidol respectively.

conclusionWhile maintaining KDIGO targets, therapeutic interventions following routine laboratory testing did not exceed six times yearly for all parameters. This suggests that a reduced testing frequency in hemodialysis patients is possible without any impact on quality of care. A personalized approach remains safe for hemodialysis patients while reducing the cost. This is very relevant in low-resource settings and during economic crises and needs to be evaluated in prospective studies.

Indexed as

AnemiaHematinicsKidney Failure, ChronicAgedFemaleFerritinsHemoglobinsHumansIronMaleMiddle AgedPhosphatesProspective StudiesRenal DialysisRetrospective StudiesFerritinsHematinicsHemoglobinsIronPhosphatesAnemiaCKD-MBDHemodialysisLaboratory testTest frequencyTreatment

Identifiers

PMID36303122
PMCPMC9615394
OpenAlexW4307640847

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.