Frequency of Routine Blood Work among Patients on Chronic Dialysis: A Narrative Review
Notice bibliographique
Résumé
Background: Home dialysis patients, including both those on hemodialysis and peritoneal dialysis, undergo monthly blood testing to identify and correct harmful laboratory abnormalities such as hyperkalemia and assess for dialysis adequacy. The frequency and utility of testing, however, is not supported by available evidence and is largely based on historical practice and expert consensus. While early identification and correction of critical laboratory values may theoretically lead to improved clinical outcomes, unnecessary testing has implications on patient quality of life, practitioner workload, use of healthcare resources and the environment. Frequent monitoring of a highly variable laboratory value (i.e., phosphate) will lead to over- or under-treatment where no outcome data exists. Methods: PubMed search identified literature on blood work frequency amongst dialysis patients of any modality. Search strategy included keywords related to blood work, lab work, frequency, and dialysis modalities. Separate searches were also performed to identify studies addressing a similar question in patients with other chronic diseases such as kidney transplant recipients and diabetes. Reference lists of relevant studies were also screened. Studies were included if they were relevant to our population of interest and addressed either the evidence behind or consequences of routine monthly blood work. Results: Overall, there are no randomized controlled studies on this topic to date. There were four observational studies comparing outcomes between in-centre hemodialysis patients undergoing monthly blood work and those receiving less frequent blood work. Of those four studies, two were conducted in Canada, one in Lebanon and one in Korea. There were no studies of patients on home dialysis including peritoneal dialysis or hemodialysis. Conclusion: There is a paucity of evidence underpinning monthly routine lab testing among home dialysis patients. Furthermore, there is little available evidence to suggest that it is unsafe to undergo less frequent testing. More high-level evidence is needed to inform an appropriate testing frequency in these patients which in turn, has the potential to transform care at the patient, provider, system, and planetary levels.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».