Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice
Purpose: As the prevalence of chronic kidney disease of non-traditional origin (CKDnt) rises in low-resource settings, there is a need for reliable point-of-care creatinine testing. The purpose of this analysis was to assess the accuracy of two commonly used point-of-care creatinine devices, the i-S...
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2023-02-01
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| Series: | Annals of Global Health |
| Subjects: | |
| Online Access: | https://annalsofglobalhealth.org/articles/3884 |
| _version_ | 1797868007605665792 |
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| author | Miranda Dally Juan José Amador Jaime Butler-Dawson Damaris Lopez-Pilarte Alexandra Gero Lyndsay Krisher Alex Cruz Daniel Pilloni Joseph Kupferman David J. Friedman Benjamin R. Griffin Lee S. Newman Daniel R. Brooks |
| author_facet | Miranda Dally Juan José Amador Jaime Butler-Dawson Damaris Lopez-Pilarte Alexandra Gero Lyndsay Krisher Alex Cruz Daniel Pilloni Joseph Kupferman David J. Friedman Benjamin R. Griffin Lee S. Newman Daniel R. Brooks |
| author_sort | Miranda Dally |
| collection | DOAJ |
| description | Purpose: As the prevalence of chronic kidney disease of non-traditional origin (CKDnt) rises in low-resource settings, there is a need for reliable point-of-care creatinine testing. The purpose of this analysis was to assess the accuracy of two commonly used point-of-care creatinine devices, the i-STAT handheld (Abbott, Princeton, NJ, USA) and the StatSensor Creatinine (Nova Biomedical, Waltham, MA, USA) in comparison to venipuncture serum creatinine measures. The affordability, sensitivity, specificity, ease of use, and other considerations for each device are also presented. Methods: Three paired data sets were compared. We collected 213 paired i-STAT and venipuncture samples from a community study in Nicaragua in 2015–2016. We also collected 267 paired StatSensor Creatinine and venipuncture samples, including 158 from a community setting in Nicaragua in 2014–2015 and 109 from a Guatemala sugarcane worker cohort in 2017–2018. Pearson correlation coefficients, Bland-Altman plots, and no intercept linear regression models were used to assess agreement between point-of-care devices and blood samples. Results: The i-STAT performed the most accurately, overestimating creatinine by 0.07 mg/dL (95% CI: 0.02, 0.12) with no evidence of proportional bias. The StatSensor Creatinine performed well at low levels of creatinine (Mean (SD): 0.87 (0.19)). Due to proportional bias, the StatSensor Creatinine performed worse in the Nicaragua community setting where creatinine values ranged from 0.31 to 7.04 mg/dL. Discussion: Both devices provide acceptable sensitivity and specificity. Although adequate for routine surveillance, StatSensor Creatinine is less accurate as the values of measured creatinine increase, a consideration when using the point-of-care device for screening individuals at risk for CKDnt. Research, clinical, and screening objectives, cost, ease of use, and background prevalence of disease must all be carefully considered when selecting a point-of-care creatinine device. Conclusion: POC testing can be more accessible in resource-limited settings. The selection of the appropriate device will depend on the use-case. |
| first_indexed | 2024-04-09T23:50:21Z |
| format | Article |
| id | doaj.art-81e0b8f976d74f84b61acca6514a0373 |
| institution | Directory Open Access Journal |
| issn | 2214-9996 |
| language | English |
| last_indexed | 2024-04-09T23:50:21Z |
| publishDate | 2023-02-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Annals of Global Health |
| spelling | doaj.art-81e0b8f976d74f84b61acca6514a03732023-03-17T12:33:44ZengUbiquity PressAnnals of Global Health2214-99962023-02-0189110.5334/aogh.38842824Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and PracticeMiranda Dally0Juan José Amador1Jaime Butler-Dawson2Damaris Lopez-Pilarte3Alexandra Gero4Lyndsay Krisher5Alex Cruz6Daniel Pilloni7Joseph Kupferman8David J. Friedman9Benjamin R. Griffin10Lee S. Newman11Daniel R. Brooks12Center for Health, Work, & Environment, Colorado School of Public Health, University of Colorado, Aurora, CO; Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CODepartment of Epidemiology, Boston University School of Public Health, Boston, MACenter for Health, Work, & Environment, Colorado School of Public Health, University of Colorado, Aurora, CO; Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CODepartment of Epidemiology, Boston University School of Public Health, Boston, MADepartment of Epidemiology, Boston University School of Public Health, Boston, MACenter for Health, Work, & Environment, Colorado School of Public Health, University of Colorado, Aurora, CO; Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, COPantaleon, Guatemala CityPantaleon, Guatemala CityDivision of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MADivision of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MADivision of Nephrology, University of Iowa, Iowa City, IowaCenter for Health, Work, & Environment, Colorado School of Public Health, University of Colorado, Aurora, CO; Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CODepartment of Epidemiology, Boston University School of Public Health, Boston, MAPurpose: As the prevalence of chronic kidney disease of non-traditional origin (CKDnt) rises in low-resource settings, there is a need for reliable point-of-care creatinine testing. The purpose of this analysis was to assess the accuracy of two commonly used point-of-care creatinine devices, the i-STAT handheld (Abbott, Princeton, NJ, USA) and the StatSensor Creatinine (Nova Biomedical, Waltham, MA, USA) in comparison to venipuncture serum creatinine measures. The affordability, sensitivity, specificity, ease of use, and other considerations for each device are also presented. Methods: Three paired data sets were compared. We collected 213 paired i-STAT and venipuncture samples from a community study in Nicaragua in 2015–2016. We also collected 267 paired StatSensor Creatinine and venipuncture samples, including 158 from a community setting in Nicaragua in 2014–2015 and 109 from a Guatemala sugarcane worker cohort in 2017–2018. Pearson correlation coefficients, Bland-Altman plots, and no intercept linear regression models were used to assess agreement between point-of-care devices and blood samples. Results: The i-STAT performed the most accurately, overestimating creatinine by 0.07 mg/dL (95% CI: 0.02, 0.12) with no evidence of proportional bias. The StatSensor Creatinine performed well at low levels of creatinine (Mean (SD): 0.87 (0.19)). Due to proportional bias, the StatSensor Creatinine performed worse in the Nicaragua community setting where creatinine values ranged from 0.31 to 7.04 mg/dL. Discussion: Both devices provide acceptable sensitivity and specificity. Although adequate for routine surveillance, StatSensor Creatinine is less accurate as the values of measured creatinine increase, a consideration when using the point-of-care device for screening individuals at risk for CKDnt. Research, clinical, and screening objectives, cost, ease of use, and background prevalence of disease must all be carefully considered when selecting a point-of-care creatinine device. Conclusion: POC testing can be more accessible in resource-limited settings. The selection of the appropriate device will depend on the use-case.https://annalsofglobalhealth.org/articles/3884chronic kidney diseasepointof- carehealth surveillanceepidemiologyclinical services |
| spellingShingle | Miranda Dally Juan José Amador Jaime Butler-Dawson Damaris Lopez-Pilarte Alexandra Gero Lyndsay Krisher Alex Cruz Daniel Pilloni Joseph Kupferman David J. Friedman Benjamin R. Griffin Lee S. Newman Daniel R. Brooks Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice Annals of Global Health chronic kidney disease pointof- care health surveillance epidemiology clinical services |
| title | Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice |
| title_full | Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice |
| title_fullStr | Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice |
| title_full_unstemmed | Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice |
| title_short | Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice |
| title_sort | point of care testing in chronic kidney disease of non traditional origin considerations for clinical epidemiological and health surveillance research and practice |
| topic | chronic kidney disease pointof- care health surveillance epidemiology clinical services |
| url | https://annalsofglobalhealth.org/articles/3884 |
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