title: Laboratory diagnostics of chronic kidney disease in Croatia: state of the art.
abstract: BACKGROUND
  Early identification and management of chronic kidney disease (CKD) is highly cost-effective and can reduce the risk of kidney failure progression and cardiovascular disease. In 2014, the Joint Croatian Working Group (JCWG) for laboratory diagnostic of CKD on the behalf of Croatian society of medical biochemistry and laboratory medicine (CSMBLM) and Croatian chamber of medical biochemists (CCMB) conducted a survey across Croatian medical-biochemistry laboratories to assess the current practice in this area of laboratory medicine. The aim of this study was to present the data collected through the survey and to give insight about laboratory diagnostics of chronic kidney disease in Croatia.
  
  
  METHODS
  An invitation to participate in the survey was sent to all Croatian medical-biochemistry laboratories (N=196). The questionnaire was designed in a form of questions and statements, with possible multiple answers, comprising 24 questions.
  
  
  RESULTS
  The response rate was 80/196 (40.8%). 39 answers were from primary medical-biochemistry laboratories. 31/78 (0.40) laboratories measure creatinine with non-standardized method (uncompensated Jaffe method). 58/78 (0.74) of laboratories that measure creatinine do not report eGFR values. Similar number of laboratories (58/80, 0.73) do not measure urine albumin or protein.
  
  
  CONCLUSIONS
  There is a large heterogeneity among Croatian laboratories regarding measuring methods, reporting units and reference intervals (cut-off values), both for creatinine and urine albumin or protein. The two key prerequisites for CKD screening, automatic reporting of eGFR and albuminuria or proteinuria assessment, are not implemented nationwide. There is a need for harmonization in laboratory diagnostics of CKD in Croatia.
authors: Department of medical biochemistry and laboratory medicine, Merkur University Hospital, Zagreb, Croatia.
authors: Vanja Radišić
authors: VR
authors: Biljak
authors: Department of medical biochemistry and laboratory medicine, General Hospital Pula, Pula, Croatia.
authors: Lorena
authors: L
authors: Honović
authors: Clinical department of laboratory diagnostics, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
authors: Jasminka
authors: J
authors: Matica
authors: Department of medical laboratory diagnostics, University Hospital Centre Split, Split, Croatia.
authors: Branka
authors: B
authors: Knežević
authors: Department of laboratory diagnostics, General County Hospital Požega, Požega, Croatia.
authors: Sanela Šimić
authors: SŠ
authors: Vojak
mesh_terms: D019411:Clinical Laboratory Techniques / Q000379:methods* / Q000592:standards*; D017523:Croatia; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: albuminuria; chronic kidney disease; creatinine; estimated glomerular filtration rate (eGFR); harmonization; proteinuria; survey