To test or not to test
======================

* Roland Jung

The authors of the clinical practice guideline for management and referral to nephrologists of patients with elevated levels of serum creatinine1 have a laudable goal of improving the care of people with renal disease. However, I was left a little uncertain as to just what it was they were recommending as the justification for and frequency of serum creatinine tests. Were they recommending this test as part of a periodic health examination or as part of case-finding or population screening?

These recommendations will be interpreted and acted upon by the family physicians in our communities. As a laboratory physician, I try to provide services within a defined budget and I have to live with recommendations and decisions taken in faraway places.

## Reference

1.  1. Mendelssohn DC, Barrett BJ, Brownscombe LM, Ethier J, Greenberg DE, Kanani SD, et al. Elevated levels of serum creatinine: recommendations for management and referral. CMAJ 1999;161(4):413-7.
    
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