Clinical Biochemistry service changes April 2022

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Clinical Biochemistry service changes April 2022

 

There are a number of changes to the Clinical Biochemistry services within NWAFT during April 2022. Please see below for details of these changes.

Reporting of estimated glomerular filtration rate (eGFR)

Estimated glomerular filtration rate is currently reported alongside serum creatinine results. In August 2021, the National Institute for Health and Care Excellence (NICE) published NG203, “Chronic Kidney Disease: assessment and management.”

NG203 recommends that the estimation of GFR (eGFR) should NOT be adjusted by an ethnicity factor.

Adjustment to eGFR equations for different ethnicities may not be valid or accurate. Categorisations based on ethnicity do not consider individuals with a diverse range of family or mixed ethnic backgrounds, and differences in eGFR across ethnicities are likely, at least in part to be due to differences in average muscle mass between ethnic groups. Additionally, muscle mass differs between individuals within the same ethnicity and an adjustment based on ethnicity may thereby be inaccurate for some people.

As such, from Tuesday 19th April 2022 eGFR reports will no longer have an accompanying comment advising that results should be adjusted for AfroCaribbean patients.

NG203 reminds of the need to use individual judgment when interpreting eGFR, for example individuals with extremes of muscle mass, adults with a high dietary protein intake.

Thyroid function test requesting

From Wednesday 20th April 2022 requests for thyroid function tests (TSH) made via CliniSys ICE order comms system will require information on whether the patient is on thyroid replacement/thyroxine treatment or not. This information will allow the laboratory to ensure that additional tests are added on appropriately in the laboratory, as well as enable appropriate interpretative comments to be added on to thyroid function test reports.

Change of referral centre for 17-OH Progesterone and Sirolimus tests

From 25th April 2022 17OH Progesterone and sirolimus tests will be referred from the PCH site to Cambridge University Hospitals (CUH) instead of the specialist laboratories currently used. Whilst there may be some differences in the analytical methods between laboratories, and hence, quantitative measurement of these samples, these differences are not expected to be significantly different. The change to CUH is expected to improve turnaround times for these tests.

Change of sample requirements for ACTH

Following information on stability of ACTH provided by the referral laboratory for this test (CUH), the sample requirements are to be updated with immediate effect. There will no longer be a requirement to contact the laboratory before sample collection, however samples should still be transported on ice and taken to the laboratory as soon as possible. The change in process is because there is no longer a requirement to centrifuge the samples in a refrigerated centrifuge.

For further information on any of these changes please contact the laboratory via email (peh-tr.chemimm@nhs.net).

Dr Mark Lum – Consultant Chemical Pathologist (Clinical lead)

Jamie West – Biochemistry Manager