Clinical Outcomes and Costs of 4-Week Versus 6-Week Bloodwork for Patients on Hemodialysis

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT03659500

Enrollment

400

Registered

2018-09-06

Start date

2012-06-01

Completion date

2015-12-31

Last updated

2024-04-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

End Stage Renal Disease

Brief summary

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.

Detailed description

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. Analytical Approach: Statistical Process Control to analyze variation in the clinical outcomes.

Interventions

DIAGNOSTIC_TESTFour-week routine bloodwork

Routine hemodialysis bloodwork done every 4 weeks

DIAGNOSTIC_TESTSix-week routine bloodwork

Routine hemodialysis bloodwork done every 6 weeks

Study design

Observational model

COHORT

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Healthy volunteers

Inclusion criteria

* all patients who received chronic hemodialysis at the Kingston Health Sciences Center regional hemodialysis program

Exclusion criteria

* none

Design outcomes

Primary

Measure	Time frame	Description
Phosphate target achievement	650 days	Proportion of patients who achieved phosphate (2.5-4.6 mg/dl)
Hemoglobin target achievement	650 days	Proportion of patients who achieved hemoglobin (10-12 g/dl)

Secondary

Measure	Time frame	Description
Calcium target achievement	650 days	Proportion of patients with calcium (8.8-10.2 mg/dl)
All-cause mortality	650 days	All-cause mortality
PTH target achievement	650 days	Proportion of patients with PTH (94-462 pg/ml)
Use of erythropoietin	650 days	Proportion of patients on erythropoietin

Other

Measure	Time frame	Description
Cost of laboratory tests	650 days	Direct costs (in CAD) of hemoglobin ($8.27), ferritin ($14.48), iron saturation ($17.58), serum calcium ($2.59), and serum phosphate ($2.59) based on the Ontario Schedule of Benefits for Laboratory Services

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026