Jeffrey Ha1,2,5, Daniel Hirsch1,2, Evan Mccauley3, Donia George1, A/Prof. Ginger Chu4,5, Ginger Chu4,5, Sradha Kotwal2,6, Kelly Lambert3,7,8
1Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia, 2Faculty of Medicine & Health, University of New South Wales Sydney, Sydney, Australia, 3Graduate School of Medicine, University of Wollongong, Wollongong, Australia, 4School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, Australia, 5Nephrology Department, John Hunter Hospital, New Lambton Heights, Australia, 6Renal and Metabolic Division, The George Institute for Global Health, UNSW Medicine & Health, Sydney, Australia, 7School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia, 8Kidney Lifestyle Research Group, University of Wollongong, Wollongong, Australia
Biography:
Ginger is an Associate Professor at the University of Newcastle. She previously worked at John Hunter Hospital as a Nephrology Clinical Nurse Consultant for 10 years and is passionate about improving patient outcomes through quality improvement and research.
Abstract:
Background. Monthly high-volume blood testing is standard across most dialysis services in Australia and New Zealand (ANZ) although some units have adopted less frequent schedules. Data on blood testing practices in ANZ haemodialysis centres is limited.
Methods. In consultation with the Renal Society of Australasia (RSA) and the ANZDATA haemodialysis working group, a cross-sectional online survey (Qualtrics, September 2025-January 2026) was conducted to characterise routine blood testing practices and perceptions regarding reduced testing frequency. The survey was distributed to renal heads of unit, dialysis unit managers, and RSA and ANZSN members. Results were summarised descriptively.
Results. A total of 142 surveys were completed, representing 70% (84/120) of ANZ haemodialysis services invited. Among the 84 participating services, 38% (30/80) continue routine monthly testing, 26% (21/80) have considered but not adopted reduced testing, 11% (9/80) are interested in changing practice, and 25% (20/80) have already implemented less frequent testing (4 non-responses). Across all respondents, key concerns regarding reduced testing frequency included risks of hyperkalaemia 30% (33/109), anaemia 29% (34/118), increased mortality 25% (30/118), haemoglobin variability 19% (23/118), and hospitalisation 19% (21/109). Cost savings and environmental sustainability were rated as very important by 36% (28/77) and 39% (30/77), respectively.
Conclusions. This binational survey highlights substantial unwarranted variation in routine blood testing practices across ANZ haemodialysis services. It also identifies key clinical concerns associated with reduced testing frequency. These findings inform ongoing implementation studies to streamline dialysis service delivery reliant on frequent blood test monitoring.