Table 2.

Survey questions for NKDEP study to assess the prevalence of eGFR reporting

Item #	Question	Response choices
1	Does your lab report serum creatinine values for adults (18 and older)?	Yes No Not sure
2	How does your lab report serum creatinine values?	mg/dL μmol/L
3	To how many decimal places do you report the creatinine result?	None One Two
4	How many serum creatinine tests did your lab perform in 2005?	Fill in the blank
5	Does your lab EVER report estimated glomerular filtration rates (eGFR) with serum creatinine determinations?	Yes No Not sure
6	Is your lab currently considering reporting eGFR with serum creatinine determinations?	Yes No Not sure
7	Under what circumstances does your lab report eGFR?	With ALL measured serum or plasma creatinine determinations Only when specifically requested Other: please specify
8	Which estimating equation do you use for your reports?	4-variable MDRD 6-variable MDRD Cockcroft-Gault Not sure Other: please specify
9	When reporting eGFR, at what point do you assign a “greater than” (>) value?	60 mL/min/1.73 m2 90 mL/min/1.73 m2 Never (we always report an exact number) Other: please specify
10	Please indicate the ONE identifier you use for your lab when submitting your CMS-116 form (CLIA Application for Certification).	See list of 26 laboratory types at: www.cms.hhs.gov/cmsforms/downloads/cms116.pdf
11	For paper-based respondents: Enter the two-letter state or territory abbreviation where your lab is located (fill in the blank)