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

Abstract

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.

Point of care creatinine testing in diagnostic imaging: A feasibility study within the outpatient computed tomography setting

“…The concordance of the study PoC device with the laboratory gold standard is consistent with other evaluations [16,17,23,24,34] and provides reassurance around the test results. Following appropriate training radiographers and support staff were able to undertake sample testing with a relatively low failure rate, which appears to reduce with experience.…”

“…Following written consent, all participants completed a screening questionnaire based on previous studies [23,24,[27][28][29], as is the local standard of care. The questionnaire sought details of known kidney disease, diabetes, heart failure, hypertension, plus history of current/recent acute illness (in…”

“…Although the screening of kidney function by blood test is only advocated in those patients with risk factors, many organisations undertake a blanket screening strategy [15]. Within the outpatient radiology setting, Point of Care (PoC) blood testing has been suggested as a mechanism for kidney function testing prior to intravascular iodinated contrast media administration and these devices have been found to be a valid alternative to laboratory testing [16][17][18][19][20][21][22][23][24][25]. Although theoretically rapid laboratory result turnaround is possible, this depends on local provision and in practice is usually more than one hour and may not complement CT operations.…”

“…The benefits of PoC have been considered to be greatest where a screening questionnaire is used to identify patients with co-morbidities which may impair kidney function[23,24,26]. However, evaluation of the implementation of such initiatives within UK NHS clinical pathways is limited[15,25].…”

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

“…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.…”