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Susan Ivy
Susan Ivy, Nurse (RN)
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Please could you tell me the routine laboratory tests done

Resolved Question:

Please could you tell me the routine laboratory tests done when on renal Dialysis.
Which tests are needed for good renal dialysis management. Which tests should be done after or before each dialysis? Which tests should be done and how frequently for the not routine tests?
Submitted: 7 years ago.
Category: Health
Expert:  Susan Ivy replied 7 years ago.
Thank you for writing to JustAnswer Health with your question.

Monthly lab values are required. Additional labs might be needed depending on the patients symptoms, and this is one reason why licensed medical personnel manage these patients while undergoing dialysis.

The monthly required labs are:
Chem 20, magnesium, pre-albumin, HBsAg, iron, transferrin, ferritin, CBC, and reticulocyte.

These are generally drawn at the beginning of the month, and the results must be back before the next dialysis session, so that adjustments can be made if needed.

I hope this helps. Please respond back to this post if you have questions or comments so that I may assist you further.
Customer: replied 7 years ago.
Dear *****,
Please tell me what all is included in a chem 20 (this is an American term and particular to a type of analyzer)Which of these chem 20 analyte's are clinically crucial for management of the patient. Our healthcare funders will only pay for what is clinically crucial to the patients well been.
How important is Ph, pco2, co2?
Which is more important Urea or Creatinin?
Why is Ca needed and is Ionised Ca better?
Expert:  Susan Ivy replied 7 years ago.
This is so very complicated, in other words, to really understand why each of these labs are needed would take several years of education.

All of these labs are indeed clinically crucial in order to maintain an individual on dialysis, a very complex procedure --- you do mean hemodialysis, correct? Rather than peritoneal dialysis? Peritoneal dialysis would also require lab work but is not quite as complicated with the fluids are being "filtered" via the abdominal fluid rather than directly from the blood stream, as in hemodialysis.

What is occurring in hemodialysis is that a machine is mimicking the renal system or kidneys. The kidneys regulate more than just the delicate fluid and electrolyte balance of the living human organism. You can't really skimp on any of these readings.

This link explains the phosphorus and calcium balance, and will help you to understand why it is so critical (calcium balance is needed to regulate the heart beat among other things - to much or too little and the heart stops) See:

The urea creatinine ratio (relationship of urea to creatinine) is a very important reading in that it shows how well the kidneys are functioning - without this reading you will not know how to set the dialysis machines. For details see:

This link explains everything that is on a chem 20, and if you click on each lab value it will link you to a detailed explanation of what the function of each test is:

This document should be some help for you in understanding dialysis requirements, in fact the items I listed on the prior post, are considered minimum requirements, an individual patient will likely need more labs that this throughout the month.

There is not a simple way to do this (set up a dialysis center) without having doctors and nurses running and consulting with you on every step of the way with(at least with the clinical aspects ). The following link should be helpful for you: (go to the section at the top left of the page titled "for professionals" then go to the forum to see discussion of experiences of those setting up hemodialysis clinics.)

I spent some time getting these particular references together for you. I hope you will take the time to read through them. There isn't a short cut for setting up something as complicated as a dialysis clinic. Still feel free to ask questions, I will do my best to answer them for you or consult with someone else if needed.
Susan Ivy and 2 other Health Specialists are ready to help you
Customer: replied 7 years ago.
Dear *****,
Thank you for all your effort. I will read everything. I am sure this will assist us in serving our customer better.
Expert:  Susan Ivy replied 7 years ago.
You are welcome, I hope this works out well for you.
Susan Ivy and 2 other Health Specialists are ready to help you