Analytical and clinical performance of three hand-held point-of-care creatinine analyzers for renal function measurements prior to contrast-enhanced imaging

Heijden, Catharina van der; Roosens, Laurence; Cluckers, Hugo; Craenenbroeck, Amaryllis H. Van; Peeters, Bart

doi:10.1016/j.cca.2019.06.025

Cited by 19 publications

(18 citation statements)

References 13 publications

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“…Studies that have used POC testing rely on a fingerprick for the POC device and venipuncture for laboratory testing. A study done in Nicaragua found POC testing for creatinine demonstrated acceptable repeatability, excellent sensitivity (100%) and modest specificity (79%) using blood samples from two different sources (forearm for Jaffe kinetic method with a Roche Cobas Integra 400 analyzer and fingerstick for POC) [26]. However, there are no available studies that compare the accuracy of solely using fingerprick capillary blood for comparable POC and IDMS results.…”

Section: Discussionmentioning

confidence: 99%

Pilot study determining the feasibility of implementing the Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol, point-of-care field measurements and a new module on risk factors for chronic kidney disease of unknown origin in Hispanic outdoor workers

2021

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Background To field test the Disadvantaged Populations eGFR Epidemiology (DEGREE) protocol, outdoor point-of-care (POC) testing for serum creatinine, and a new risk factor module on chronic kidney disease of undetermined origin (CKDu) in U.S. outdoor Hispanic workers. Methods Fifty workers were interviewed in Houston (TX). DEGREE and CKDu questionnaires were completed indoors. Anthropometrics and paired blood samples for POC and laboratory assay were completed outdoors over two periods (November–December 2017, April–May 2018). Results Administration of DEGREE and CKDu questionnaires averaged 10 and 5 min, respectively, with all questions easily understood. We observed high correlations between POC and IDMS creatinine (r = 0.919) and BUN (r = 0.974). The POC device would disable testing when outdoor temperatures were above 85 °F or below 65 °F; this was adjustable. Conclusions Implementation of DEGREE and the new CKDu module was straightforward and well understood. The POC device performed well in the field, with some adjustment in methods when temperature readings were out of range.

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Section: Discussionmentioning

confidence: 99%

Pilot study determining the feasibility of implementing the Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol, point-of-care field measurements and a new module on risk factors for chronic kidney disease of unknown origin in Hispanic outdoor workers

2021

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“…Moreover, significant bias has been reported between the creatinine measured on Nova StatSensor and routine laboratory enzymatic methods [ 16 , [19] , [20] , [21] , [22] , [23] ]. The StatSensor and the iSTAT, have been reported to exhibit a bias in creatinine of +16% and +6% respectively against the routine laboratory analyzers [ 5 ]. Thus, biases in creatinine measurement have been shown across different POCT devices compared with other POCT or routine laboratory analyzers.…”

Section: Discussionmentioning

confidence: 99%

“…The epoc® Blood Analysis System (Siemens Healthineers, Oakville, Ontario, Canada) is a relatively newer, portable, point-of-care (POCT) device and has recently been compared to various other POCT, blood gas, and hematology instruments [ [1] , [2] , [3] , [4] , [5] ]. This system is comprised of credit card-sized test cards and a wireless card reader.…”

Section: Introductionmentioning

confidence: 99%

“…The epoc® system imparts key advantages including the availability of single-use cards that can be stored at room temperature, wireless connectivity and fast turnaround time, making it a suitable system for several settings. As a result, various reports have validated the use of the epoc® in surgical, intensive care, emergency and outpatient hospital units [ [1] , [2] , [3] , 5 ], where these analyzers are in high demand.…”

Section: Introductionmentioning

confidence: 99%

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Performance evaluation of all analytes on the epoc® Blood Analysis System for use in hospital surgical and intensive care units

Mohammed‐Ali¹,

Bagherpoor

Diker

et al. 2020

Practical Laboratory Medicine

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Objective To evaluate the performance of the epoc hand-held analyzer against the RAPIDPoint 500 blood gas analyzer and laboratory analyzers where applicable. Methods Venous or arterial whole blood samples collected in balanced heparinized syringes were obtained from 69 patients (35 females, 34 males) predominantly (77%) from the surgical unit and intensive care unit (ICU). Method comparison was performed for all analytes on the epoc System against the RAPIDPoint 500 Blood gas analyzer or laboratory analyzers where applicable. Results: Mean bias was <5% for blood gases, electrolytes, lactate and glucose. Hematocrit showed a bias of -6.76% (95% CI = -8.91, - 4.61) compared to the HemataSTAT-II method, whereas calculated total hemoglobin showed a bias of 1.51% (95% CI = -1.04, 4.06) against the Sysmex XN-10 hematology analyzer. Creatinine showed the largest bias relative to laboratory analyzers, Abbott Architect c8000 Jaffe method (13.54%, 95% CI = 5.43, 21.65) and Roche Cobas c702 enzymatic method (30.01%, 95% CI = 12.64, 47.38). Conclusions: The epoc system is fit for use in the surgical and ICU setting for the measurement of all analytes except for creatinine.

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“…Studies comparing the performance of the i-STAT device to other platforms have been inconsistent. 35 , 36 , 37 , 38 One study showed that the i-STAT overestimated creatinine results by 3.88 µmol/L in comparison to the Roche enzymatic creatinine results. This overestimation occurred predominantly at higher creatinine concentrations.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the impact of delayed centrifugation on the diagnostic performance of serum creatinine as a baseline measure of renal function before antiretroviral treatment

Chikomba

Padoa

Tanyanyiwa

2020

Southern African Journal of HIV Medicine

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Background The measurement of serum creatinine is a standard requirement of the medical management of people living with HIV. Renal dysfunction is common, both as a complication of HIV-infection and as a result of its treatment. The detection of abnormal renal function before the start of antiretroviral therapy will impact patient management and the outcome of treatment. Objectives This study aimed to determine if a time delay in the centrifugation of serum samples affected the creatinine level and the estimated glomerular filtration rate as recorded on the analytical platforms used in the laboratory. Methods Twenty-two ( n = 22) HIV-positive, newly diagnosed and treatment-naïve patients were randomly recruited from Alexandra Health Clinic, Johannesburg, South Africa. Serum samples were centrifuged at six time intervals following receipt of the sample viz. < 4 h (baseline), 6 h, 24 h, 48 h, 72 h and 96 h. Creatinine concentrations were measured on the Roche platform utilising the enzymatic and kinetic Jaffe methods. Whole blood samples were also analysed with the Abbott i-STAT point-of-care instrument. The estimated glomerular filtration rate was calculated using the Cockcroft Gault, CKD–Epidemiology Collaboration and Modified Diet and Renal Disease v3/4 equations. Results At baseline (< 4 h) there was good agreement between the enzymatic and kinetic Jaffe methods: bias 1.7 µmol/l. The enzymatic and i-STAT creatinine concentrations were stable over 96 h viz. changes of 1.8% and 5.7%. However, from 24 h onwards agreement between the enzymatic and kinetic Jaffe methods was poor with the latter measuring 43.7 µmol/l higher than the enzymatic method at 96 h. Creatinine concentrations measured with the kinetic Jaffe method increased significantly in samples centrifuged after 6 h ( p < 0.001, 61.7% change), and resulted in a 95% decline in eGFR at 96 h as determined with the CKD–Epidemiology Collaboration equation. Conclusion The analysis of serum creatinine using the isotope dilution mass spectrometry traceable kinetic Jaffe method is unreliable if performed on samples centrifuged ≥ 6 h after collection. The raised creatinine concentration can affect clinical decisions such as renal functional assessment, choice of antiretroviral drug or regimen, and the dose and frequency of medication.

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Analytical and clinical performance of three hand-held point-of-care creatinine analyzers for renal function measurements prior to contrast-enhanced imaging

Cited by 19 publications

References 13 publications

Pilot study determining the feasibility of implementing the Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol, point-of-care field measurements and a new module on risk factors for chronic kidney disease of unknown origin in Hispanic outdoor workers

Pilot study determining the feasibility of implementing the Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol, point-of-care field measurements and a new module on risk factors for chronic kidney disease of unknown origin in Hispanic outdoor workers

Performance evaluation of all analytes on the epoc® Blood Analysis System for use in hospital surgical and intensive care units

Evaluation of the impact of delayed centrifugation on the diagnostic performance of serum creatinine as a baseline measure of renal function before antiretroviral treatment

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