Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice.

IF 2.6 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Global Health Pub Date : 2023-02-01 eCollection Date: 2023-01-01 DOI:10.5334/aogh.3884

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

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引用次数: 0

Abstract

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.

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非传统来源慢性肾病的护理点检测：临床、流行病学和健康监测研究与实践的考虑因素》。

目的：随着非传统来源慢性肾脏病（CKDnt）发病率在低资源环境中的上升，需要进行可靠的床旁肌酐检测。本分析的目的是评估两种常用的床旁肌酐检测设备（i-STAT 手持式（雅培，美国新泽西州普林斯顿）和 StatSensor Creatinine（Nova Biomedical，美国马萨诸塞州沃尔瑟姆））与静脉穿刺血清肌酐测量的准确性。此外，还介绍了每种设备的可负担性、灵敏度、特异性、易用性和其他注意事项：比较了三组配对数据。我们从 2015-2016 年尼加拉瓜的一项社区研究中收集了 213 份成对的 i-STAT 和静脉穿刺样本。我们还收集了 267 份成对的 StatSensor 肌酐和静脉穿刺样本，其中 158 份来自 2014-2015 年尼加拉瓜的社区环境，109 份来自 2017-2018 年危地马拉的甘蔗工人队列。使用皮尔逊相关系数、Bland-Altman 图和无截距线性回归模型来评估护理点设备和血液样本之间的一致性：结果：i-STAT 的准确度最高，肌酐高估了 0.07 mg/dL (95% CI: 0.02, 0.12)，没有证据表明存在比例偏差。StatSensor Creatinine 在肌酐水平较低时表现良好（平均值（标度）：0.87 (0.19)）。由于比例偏差，StatSensor Creatinine 在尼加拉瓜社区环境中的表现较差，那里的肌酐值在 0.31 到 7.04 mg/dL 之间：两种设备都具有可接受的灵敏度和特异性。尽管 StatSensor Creatinine 可满足常规监测的要求，但随着测量肌酐值的增加，其准确性也会降低，这也是使用床旁设备筛查 CKD 高危人群时需要考虑的因素。在选择护理点肌酐设备时，必须仔细考虑研究、临床和筛查目标、成本、易用性和疾病的背景流行率：结论：在资源有限的环境中，POC 检测更容易获得。结论：在资源有限的环境中，POC 检测更容易获得。选择合适的设备取决于使用情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

5.30

自引率

3.40%

发文量

审稿时长

11 weeks

期刊介绍： ANNALS OF GLOBAL HEALTH is a peer-reviewed, open access journal focused on global health. The journal’s mission is to advance and disseminate knowledge of global health. Its goals are improve the health and well-being of all people, advance health equity and promote wise stewardship of the earth’s environment. The journal is published by the Boston College Global Public Health Program. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health.