{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:50:05Z","timestamp":1776905405287,"version":"3.51.2"},"reference-count":8,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n There is limited evidence to guide optimal frequency of surveillance bloodwork for haemodialysis patients. In September 2023, surveillance bloodwork frequency was reduced from monthly to 6\u2010weekly across 4 Illawarra\u2010Shoalhaven dialysis units. We retrospectively evaluated actual frequency of blood tests, safety (all\u2010cause hospitalisations, hospitalisations for hyperkalaemia, percentage of potassium and haemoglobin levels in target ranges), cost\u2010savings and environmental impact (reduction in carbon emissions and waste generation) of 6\u2010weekly versus monthly scheduled bloodwork for clinically stable patients receiving in\u2010facility haemodialysis during the 12\u2010months before and after this practice change. Staff perspectives were gathered via survey. We analysed 99 patients with monthly surveillance bloodwork and 101 patients with 6\u2010weekly bloodwork. After reducing to 6\u2010weekly scheduled bloodwork, frequency of FBC\/EUC\/CMP blood tests decreased from 48.3 to 34.9 per patient\u2010year. Comparing 6\u2010weekly versus monthly groups, there was no increase in percentage of patients with \u2265\u20091 hospitalisation (72% vs. 73.5%,\n p<\/jats:italic>\n \u2009=\u20090.70), hospitalisation for hyperkalaemia (0.8% vs. 0.9%,\n p<\/jats:italic>\n \u2009=\u20090.92); percentage of patients with potassium levels (3.5\u20135.9\u2009mmol\/L) was similar (86.0% vs. 86.2%,\n p<\/jats:italic>\n \u2009=\u20090.88). Proportion of haemoglobin levels in target range (100\u2013115\u2009g\/L) decreased from 45.4% to 38.5% (\n p<\/jats:italic>\n \u2009<\u20090.01) but with no clear changes in Erythropoietin Stimulating Agent use. Overall, there were 3.8 fewer blood draws, 8.7 fewer blood tubes used, $AUD201.44 saved in pathology costs and carbon emissions reduced by 1.03\u2009kg per patient\u2010year. Of 58 dialysis nurses, 47 (81%) responded to a survey and indicated the practice change was acceptable (38\/47, 81%). Reducing surveillance bloodwork frequency to 6\u2010weekly for haemodialysis patients delivered substantial cost\u2010savings and had positive environmental benefits without compromising safety. Strong engagement with dialysis staff supports its scalability and sustainability.\n <\/jats:p>","DOI":"10.1111\/nep.70202","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T06:23:51Z","timestamp":1775111031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Six\u2010Weekly Versus Monthly Haemodialysis Blood Testing in an Australian Tertiary Kidney Service: A Quality, Safety, Green Nephrology Initiative and Cost\u2010Saving Analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6390-9508","authenticated-orcid":false,"given":"Daniel","family":"Hirsch","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"},{"name":"Faculty of Medicine & Health University of New South Wales Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donia","family":"George","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie","family":"Pugh","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Kwiatkowski","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Staker","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jake","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny H. C.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"},{"name":"Graduate School of Medicine University of Wollongong Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5935-7328","authenticated-orcid":false,"given":"Kelly","family":"Lambert","sequence":"additional","affiliation":[{"name":"School of Medical, Indigenous and Health Sciences University of Wollongong Wollongong New South Wales Australia"},{"name":"Kidney Lifestyle Research Group University of Wollongong Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4827-6981","authenticated-orcid":false,"given":"Karumathil","family":"Murali","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"},{"name":"Graduate School of Medicine University of Wollongong Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3387-3743","authenticated-orcid":false,"given":"Wing\u2010Chi Gigi","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"},{"name":"Faculty of Medicine & Health University of New South Wales Sydney Sydney New South Wales Australia"},{"name":"Renal and Metabolic Division The George Institute for Global Health, UNSW Medicine & Health Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8558-1697","authenticated-orcid":false,"given":"Jeffrey T.","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Wollongong Hospital Wollongong New South Wales Australia"},{"name":"Faculty of Medicine & Health University of New South Wales Sydney Sydney New South Wales Australia"},{"name":"Renal and Metabolic Division The George Institute for Global Health, UNSW Medicine & Health Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2022060661"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806\u20109282.64.12.1108"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2018.10.008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.08.016"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/20543581241255784"},{"key":"e_1_2_10_7_1","unstructured":"M. R.CD E.Au S.Bateman et\u00a0al. \u201c47th Report Chapter\u00a04: Haemodialysis \u201dAustralia and New Zealand Dialysis and Transplant Registry Adelaide Australia 2024 http:\/\/www.anzdata.org.au."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50839"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13560"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70202","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70202","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:08:04Z","timestamp":1776902884000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/nep.70202"],"URL":"https:\/\/doi.org\/10.1111\/nep.70202","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70202"}}