Innovative Use of Point-of-Care Testing for Chronic Kidney Disease Screening

Shephard, Anne; Shephard, Mark Douglas; Halls, Heather; Corso, Olivia; Mathew, Timothy H.

doi:10.1097/poc.0b013e31821c6bd0

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…The types of available POCT also vary from basic tests to more advanced tests such as HbA1c (25). Point-of-care testing is not new and has been well studied (26)(27)(28)(29)(30)(31)(32)(33)(34). Relatively few studies have examined its use in primary care settings (27,28,30,32), and none has been published from the Caribbean.…”

Section: Discussionmentioning

confidence: 99%

“…Relatively few studies have examined its use in primary care settings (27,28,30,32), and none has been published from the Caribbean. Several studies have examined the clinical effectiveness, diagnostic accuracy, patient satisfaction and cost-effectiveness of POCT (26,27), improved compliance (28,29), stronger doctor-patient relationships (30), optimal glycaemic control (31), and equivocal cost (33,34).…”

Section: Discussionmentioning

confidence: 99%

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Screening for Non-communicable Diseases at a Walk-in Clinic in Trinidad, West Indies: A Time-motion Cross-sectional Study and Net Present Value Analysis

Maharaj¹,

Teelucksingh²,

Chow³

et al. 2017

West Indian Med J

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Objective: To determine the feasibility of recommending a screening process for non-communicable diseases (NCDs) and their risk factors, as a national and regional model. Methods: A cross-sectional, six-station process was carried out. It consisted of invitation and consent, history (personal and family history of NCDs), biometrics (waist circumference and body mass index), blood levels (lipids and glycosylated haemoglobin) and urinalysis (microalbuminuria), basic examinations (blood pressure, peripheral neuropathy, presence of acanthosis nigricans and visual acuity), and an exit interview. Net present value (NPV) calculations were carried out for very high-risk patients (those with a > 30% risk of a cardiovascular event (limb amputation) in the next 10 years) for two discount rates: 0.75% (United States of America) and 3.4% (Trinidad and Tobago). Results: A convenience sample of 514 walk-in patients (56.2% recruitment rate) was screened (about 23 patients per day). The median time for a patient attending all stations was 21 minutes (range: 11-59 minutes). Of the six stations, the laboratory took the longest: median 10 minutes (range: 2-50 minutes). The entire project cost US$20 439 (US$39.76 per patient). Between one and seven very high-risk patients (three subgroups of patients had this risk profile) were

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Screening for Non-communicable Diseases at a Walk-in Clinic in Trinidad, West Indies: A Time-motion Cross-sectional Study and Net Present Value Analysis

Maharaj¹,

Teelucksingh²,

Chow³

et al. 2017

West Indian Med J

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“…However, the available POCTs for the measurements of these parameters are not currently authorized for home use [ 21 ]. The reason for this is related to possible interference due to the complexity of the creatinine specimen matrix, as well as the haemolysis associated with finger-pricking, which makes a potassium measurement almost impossible via the POCT-associated method [ 84 ]. Very recently, Yonel Z. and coworkers determined the concordance of three POCT devices, i.e., (Nova StatSensor (creatinine/eGFR); Siemens DCA-Vantage (HbA1C); CityAssays (vitamin-D), with laboratory-based standard assays employed within clinical biochemistry laboratories.…”

Section: Ckd Management and Available Poctmentioning

confidence: 99%

Lab on a Chip Device for Diagnostic Evaluation and Management in Chronic Renal Disease: A Change Promoting Approach in the Patients’ Follow Up

et al. 2023

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Lab-on-a-chip (LOC) systems are miniaturized devices aimed to perform one or several analyses, normally carried out in a laboratory setting, on a single chip. LOC systems have a wide application range, including diagnosis and clinical biochemistry. In a clinical setting, LOC systems can be associated with the Point-of-Care Testing (POCT) definition. POCT circumvents several steps in central laboratory testing, including specimen transportation and processing, resulting in a faster turnaround time. Provider access to rapid test results allows for prompt medical decision making, which can lead to improved patient outcomes, operational efficiencies, patient satisfaction, and even cost savings. These features are particularly attractive for healthcare settings dealing with complicated patients, such as those affected by chronic kidney disease (CKD). CKD is a pathological condition characterized by progressive and irreversible structural or functional kidney impairment lasting for more than three months. The disease displays an unavoidable tendency to progress to End Stage Renal Disease (ESRD), thus requiring renal replacement therapy, usually dialysis, and transplant. Cardiovascular disease (CVD) is the major cause of death in CKD, with a cardiovascular risk ten times higher in these patients than the rate observed in healthy subjects. The gradual decline of the kidney leads to the accumulation of uremic solutes, with negative effect on organs, especially on the cardiovascular system. The possibility to monitor CKD patients by using non-invasive and low-cost approaches could give advantages both to the patient outcome and sanitary costs. Despite their numerous advantages, POCT application in CKD management is not very common, even if a number of devices aimed at monitoring the CKD have been demonstrated worldwide at the lab scale by basic studies (low Technology Readiness Level, TRL). The reasons are related to both technological and clinical aspects. In this review, the main technologies for the design of LOCs are reported, as well as the available POCT devices for CKD monitoring, with a special focus on the most recent reliable applications in this field. Moreover, the current challenges in design and applications of LOCs in the clinical setting are briefly discussed.

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“…7,8 Point-of-care (PoC) creatinine testing has found utility in human medicine in both screening programmes for the prevalence of CKD and early identification of kidney injury in at-risk patients. [9][10][11] PoC analysers typically have small sample requirements and a rapid turnaround time, providing real-time clinical information. [11][12][13][14][15] A PoC creatinine analyser is an attractive tool in feline clinical practice, given the high incidence of CKD in this species and their relative risk of kidney injury.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a handheld point-of-care analyser for measurement of creatinine in cats

Reeve

Warman

Lewis³

et al. 2016

Journal of Feline Medicine and Surgery

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Objectives: To evaluate whether a hand-held creatinine analyser (StatSensor ® Xpress; SSXp), available for human patients, can be used to reliably measure creatinine in cats.Methods: Analytical performance was evaluated by determining within-run and between-run coefficient of variation (CV, %), total error observed (TEobs, %) and sigma metrics. 50 client-owned cats presenting for investigation of clinical disease had creatinine measured simultaneously, using SSXp (whole blood and plasma) and a reference instrument (Konelab, serum); 48 paired samples were included in the study. Creatinine correlation between methodologies (SSXp vs Konelab) and sample types (SSXpwhole blood vs SSXpplasma) was assessed by Spearman's correlation coefficient and agreement was determined using Bland-Altman difference plots. Each creatinine value was assigned an IRIS stage (1-4); correlation and agreement between Konelab and SSXp IRIS stages was evaluated. Conclusions and relevance:Analytical performance of the SSXp in feline patients is not considered acceptable. The SSXp exhibited high to very-high correlation compared to reference methodology but the two instruments cannot be used interchangeably. Improvements in SSXp analytical performance are needed before its use can be recommended in feline clinical practice.

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Innovative Use of Point-of-Care Testing for Chronic Kidney Disease Screening

Cited by 7 publications

References 10 publications

Screening for Non-communicable Diseases at a Walk-in Clinic in Trinidad, West Indies: A Time-motion Cross-sectional Study and Net Present Value Analysis

Screening for Non-communicable Diseases at a Walk-in Clinic in Trinidad, West Indies: A Time-motion Cross-sectional Study and Net Present Value Analysis

Lab on a Chip Device for Diagnostic Evaluation and Management in Chronic Renal Disease: A Change Promoting Approach in the Patients’ Follow Up

Evaluation of a handheld point-of-care analyser for measurement of creatinine in cats

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