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    Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility

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    Publication date
    2018
    Author
    Snaith, Beverly
    Harris, Martine A.
    Shinkins, B.
    Jordaan, M.
    Messenger, M.
    Lewington, A.
    Keyword
    Contrast-induced acute kidney injury
    Contrast media
    Creatinine
    Diagnostic imaging
    Estimated glomerular filtration rate
    Kidney diseases
    Point-of-care testing
    Rights
    © 2018 Walter de Gruyter GmbH. Full-text reproduced in accordance with the publisher’s self-archiving policy.
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    Acute kidney injury (AKI) can occur rarely in patients exposed to iodinated contrast and result in contrast-induced AKI (CI-AKI). A key risk factor is the presence of pre-existing chronic kidney disease (CKD), therefore it is important to assess patient risk and obtain kidney function measurement prior to administration. Point of care (PoC) testing provides an alternative strategy but there remains uncertainty, with respect to diagnostic accuracy and clinical utility. A device study compared three PoC analysers (Nova StatSensor, Abbott i-STAT, Radiometer ABL800 FLEX) with a reference laboratory standard (Roche Cobas 8000 series, enzymatic creatinine). Three hundred adult patients attending a UK hospital phlebotomy department were recruited to have additional blood samples for analysis on the PoC devices. The ABL800 FLEX had the strongest concordance with laboratory measured serum creatinine (mean bias=-0.86, 95% limits of agreement = -9.6 to 7.9) followed by the i-STAT (average bias=3.88, 95% limits of agreement = -8.8 to 16.6) and StatSensor (average bias=3.56, 95% limits of agreement = -27.7 to 34.8). In risk classification, the ABL800 FLEX and i-STAT identified all patients with an eGFR≤30, whereas the StatSensor resulted in a small number of missed high-risk cases (n=4/13) and also operated outside of the established performance goals. The screening of patients at risk of CI-AKI may be feasible with PoC technology. However in this study it was identified that the analyser concordance with the laboratory reference varies. It is proposed that further research exploring PoC implementation in imaging department pathways is needed.
    URI
    http://hdl.handle.net/10454/15685
    Version
    Accepted Manuscript
    Citation
    Snaith B, Harris MA, Shinkins B et al (2018) Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility. Clinical Chemistry and Laboratory Medicine. 56(8): 1269-1276.
    Link to publisher’s version
    https://doi.org/10.1515/cclm-2018-0128
    Type
    Article
    Collections
    Health Studies Publications

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