Clinical Outcomes and Costs of 4-Week Versus 6-Week Bloodwork for Patients on Hemodialysis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 400
- 主要终点
- Phosphate target achievement
研究概览
简要总结
The objective of this quality improvement study was to determine the effect of an institution-wide switch of routine bloodwork from four-week intervals to six-week intervals on the achievement of anemia and chronic kidney disease-mineral and bone disorder (CKD-MBD) targets for patients on chronic hemodialysis.
详细描述
Rationale & Objective: Routine bloodwork for patients on hemodialysis has both financial and opportunity costs, but there is little data on how the frequency of measurement affects patient outcomes. Our objective was to determine the effect of changing from routine bloodwork at four-week intervals to six-week intervals on the achievement of anemia and chronic kidney disease-mineral and bone disorder (CKD-MBD) targets.
Study Design: Retrospective interrupted time series from June 1, 2012 to December 31, 2015.
Setting & Participants: Tertiary hospital in Ontario, Canada, that provides hemodialysis to 350-400 adult patients.
Quality Improvement Activities: Institution-wide switch of routine bloodwork from four-week intervals to six-week intervals on March 24, 2014.
Outcomes: Proportion of patients who achieved recommended hemoglobin and phosphate targets. In a 252-day sub-analysis, we also calculated the cost-savings attributable to a change in laboratory testing frequency for hemoglobin, ferritin, iron saturation, calcium, and phosphate.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •all patients who received chronic hemodialysis at the Kingston Health Sciences Center regional hemodialysis program
排除标准
- 未提供
结局指标
主要结局
Phosphate target achievement
时间窗: 650 days
Proportion of patients who achieved phosphate (2.5-4.6 mg/dl)
Hemoglobin target achievement
时间窗: 650 days
Proportion of patients who achieved hemoglobin (10-12 g/dl)
次要结局
- PTH target achievement(650 days)
- All-cause mortality(650 days)
- Use of erythropoietin(650 days)
- Calcium target achievement(650 days)
研究者
Samuel Silver
Assistant Professor
Queen's University