Evaluation of Kidney Function Testing Practices among Medical Laboratories in Ghana

Background Kidney function is assessed to detect kidney diseases and help manage individuals with kidney diseases or pathologies that impair the function of the kidneys. Better diagnostic methods that enable early detection of kidney diseases are vital for reversing the disorders in the early stages. This would ultimately prevent progression to advanced stages with significant economic burden and a negative impact on quality of life. This study examined the kidney function testing practices among medical laboratories in Ghana. Methods A structured Google questionnaire form was conveniently used to collect data from 220 medical laboratories across fourteen (14) regions in Ghana. Results All the teaching hospitals and regional hospitals carry out kidney/renal function tests, with only 79.1% of district hospitals performing such tests. There was no standard nomenclature for such tests. The alkaline picrate (Jaffe’s) method is used by most of the facilities (61.8%) for creatinine estimation, with enzymatic methods used by 58.8%. Most of the facilities did not know whether their creatinine is automatically calibrated to isotope dilution mass spectrometry (IDMS) or not, with 32% reporting their creatinine is calibrated by the manufacturer. Only 9% of facilities correct their creatinine values. For the Glomerular filtration rate (GFR) estimation, 50.6% use the CKD-EPI formula, 15.2% use the Cockcroft-Gault formula, and 14.6% the use MDRD formula in adults. For children, a majority (37.3%) use the CKD-EPI formula, 15.8% use the Cockcroft-Gault formula, 12.7% use the Schwartz formula and 10.8% use the MDRD formula. AKIN, RIFLE, and KDIGO criteria were each used by < 6% of the facilities. Conclusions We recommend that nationwide training, with a well-developed national guideline on kidney function testing, should be organized for scientists on kidney function tests and their limitations.