Purpose
Impaired renal excretory function is the most significant risk factor for contrast induced nephropathy (CIN) and nephrogenic systemic fibrosis (NSF).
Thus,
measurement of serum creatinine and calculation of estimated glomerular filtration rate (eGFR) is mandatory before administration of iodinated or Gd-based contrast agents,
especially in high-risk patients.
As routine laboratory creatinine measurement is a time-consuming procedure especially in radiologic practice and in an out-patient setting,
it would be desirable to have a fast and reliable tool for point-of-care (POC) creatinine measurement.
The StatSensor® Creatinine Hospital...
Methods and Materials
This was a prospective study of 612 patients who were scheduled for contrast enhanced computed tomography.
Whole blood capillary and venous samples were collected and measured with StatSensor® Creatinine and compared to a venous blood sample measured by the central laboratory method (reference method) Estimated glomerular filtration rate (eGFR) was calculated by the Cockcroft-Gault equation.
Bland-Altman plots were used for the evaluation of measurement agreement.
An eGFR of 60,
45 and 30 ml/min/1.73m² was chosen to distinguish between normal and abnormal renal function,
respectively.
Results
The laboratory gold standard yielded a significantly higher mean eGFR value when compared to the capillary and venous blood analysis of the StatSensor® (p<0.001,
respectively).
Agreement plots and Bland-Altman plots are for the venous measurements are shown in Figures 1 and 2,
those for the capillary measurement are shown in Figure 3 and 4.
These plots show a good agreement of eGFR-values calculated on the basis of the StatSensor® creatinine measurements and the gold standard.
This was especially true for patients with an eGFR<90 ml/min/1.73m²....
Conclusion
The StatSensor® creatinine meter is a reliable tool in the screening for patients with renal dysfunction with high negative predictive values.
Due to low positive predictive values,
caution should be exercised in case of positive results,
which should be validated by standard laboratory measurement.