Online Publication Date:
23 Jul 2018
5 Things Physicians and Patients Should Question in Pediatric Nephrology - The Choose Wisely Campaign

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:

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.
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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 .

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