Paramedical personnel in evaluating children with renal disease

During the past four years we have utilized the Clinical Laboratory Patient Service Assistant to help us evaluate children with renal disease. She arranges, conducts and calculates all studies, except for performing the renal biopsy. This has permitted us to evaluate 450 children with renal disease, including 2,000 complete series of renal function studies and 300 renal biopsies. Previously, this diagnostic work-up required 5.5 hospital days. The Clinical Lab. Patient Service Assistant has permitted us to evaluate each patient in the outpatient dept. in 7 hours (overnight hospitahzation required for renal biopsy). The studies include two 12-hour urine collections in the recumbent and ambulatory positions (done prior to coming to the hospital), concentrating and diluting capacity, urine culture and urinalysis, creatinine and urea clearance, tubular resorption of phosphate, blood gases, appropriate serological studies and blood chemistries, and a water load test. An intravenous pyelogram and voiding cystogram can be done before and after the studies are completed, respectively. The Clinical Laboratory Patient Service Assistant has permitted us to decrease hospitalization time, decrease expenses to the family for lodging, decrease cost to the insurance carrier and the time of confinement in the hospital. She represents a familiar friend to the children with renal disease whom we follow.