The American Academy of Pediatrics (AAP), in conjunction with the American Society of Pediatric Nephrology (ASPN), as part of the Choosing Wisely® campaign, recently “released a list of specific nephrology tests and procedures that are commonly ordered but not always necessary when treating children for kidney-related conditions”.
The Choosing Wisely recommendations include:
- Do not order routine screening urine analyses in healthy, asymptomatic pediatric patients as part of routine well child care.
- Do not initiate a work up for hematuria or proteinuria before repeating an abnormal urine dipstick analysis.
- Avoid ordering follow-up urine cultures after treatment for an uncomplicated urinary tract infection in patients that show evidence of clinical resolution of infection.
- Do not initiate an outpatient hypertension work-up in asymptomatic pediatric patients prior to repeating the blood pressure measurement.
- Do not place central lines or peripherally inserted central lines in pediatric patients with advanced (Stage 3-5) chronic kidney disease/end-stage renal disease without consultation with pediatric nephrology due to goals to avoid adverse events, preserve long-term vascular access, and avoid unnecessary and costly procedures.
Choosing Wisely® is an initiative of the ABIM Foundation, which seeks to promote conversations between clinicians and patients in choosing care that is supported by evidence; does not duplicate other tests or procedures already received; is free from harm; and truly necessary.
At least 80 medical specialty societies have published more than 500 recommendations of overused tests and treatments as a result of the initiative, launched in 2012.
For more information please visit the release from The American Academy of Pediatrics.
