rounded to the nearest 0.1 mg/dL for at least a segment
of the population. For the 1. 2 million patients across all
27 organizations, 34.3% of patients had a second digit
of 0, suggesting rounded SCr measurements.
Precise Measurement by Organization
Questions to Consider
■ ■ How many different labs measure and report serum
creatinine for your organization? Do any SCr measurements get processed in-house?
■ ■ Do labs report SCr rounded to the 0.1 or 0.01 mg/
dL? Does it depend on the lab?
■ ■ How is eGFR calculated (e.g., is it calculated by
the lab, in the EHR, by a physician at the point of
■ ■ Does anyone have concerns about the precision of
SCr measurements and the implications that has on
eGFR values and clinical practice?
■ ■ How do you change the precision with which labs
report SCr measurements?
1. International Society of Nephrology. 2013. KDIGO2012 Clinical Practice Guideline for the Evaluation and Management of
Chronic Kidney Disease. Kidney International Supplements,
3( 1). Accessed September 12, 2017 at kdigo.org/clinical_prac-
Nikita Stempniewicz is senior population health
analyst and Elizabeth Ciemins, Ph.D., M.P.H., M.A.,
is director, research and analytics, at AMGA. Please
contact Nikita Stempniewicz (nstempniewicz@amga.
org) with questions regarding the analysis.
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Shannon L. McKay, Vice President
Adkisson Search Consultants
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