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. 2021;5(6):638-650.
doi: 10.26502/fccm.92920229. Epub 2021 Dec 3.

Point-of-Care Capillary Blood Creatinine: A Prospective study in Cardiology and Nephrology Outpatients

Eve Vilaine  1   2 , Paul Gabarre  1 , Alain Beauchet  3 , Alexandre Seidowsky  1   4 , Olivier Auzel  5   6 , Marie Hauguel-Moreau  5 , Olivier Dubourg  5   7 , Nicolas Mansencal  5   7 , Marie Essig  1   7 , Ziad A Massy  1   7
Affiliations

Point-of-Care Capillary Blood Creatinine: A Prospective study in Cardiology and Nephrology Outpatients

Eve Vilaine et al. Cardiol Cardiovasc Med. 2021.

Abstract

Background: The radiological or interventional use of contrast medium exposes patients to a risk of contrast-induced nephropathy. Pre-existing kidney failure is a major risk factor. Point-of-Care Capillary blood creatinine tests are promising; their speed might help to optimize treatment decisions and patient care in these situations.

Methods: The objective of the present study was to assess the ability of a new point of care capillary blood creatinine test (Stat Sensor X-press, Nova Biomedical Cooperation, Waltham, MA, USA) to diagnose kidney failure, relative to a standard lab-based plasma creatinine assay. A total of 113 patients 33 women (29.2%) were included. The capillary blood creatinine concentration was significantly correlated with the plasma creatinine concentration in both men (Pearson's r [95% Confidence Interval (CI)] = 0.84 [0.75 - 0.89]; p<0.001) and women (Pearson's r [95%CI] = 0.95 [0.89 - 0.97]; p<0.001). The test's diagnostic performance was satisfactory, its sensitivity was 70% [35 - 93] in women and 78% [52 - 94] in men, and its specificity was 91% [72 - 99] in woman and 93% [84 - 98] in men.

Conclusion: Rapid Point-of Care Capillary creatinine test is an easy-to-use, accurate tool for detecting kidney failure before a patient is exposed to procedures involving contrast medium. The POC test performed less well in patients over the age of 75 and in patients with high plasma creatinine level.

Keywords: Capillary blood; Nephroprotection; POC; Point-of-care blood creatinine test; contrast-induced nephropathy.

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Conflict of interest statement

Competing interests The authors declare that they have no competiting of interests.

Figures

Figure 1:
Figure 1:
A. Correlation between Ccap(μmol/l) and Cpl(μmol/l) in women(n=30). The horizontal and vertical lines represent the threshold for definition of the true positive (i.e. 96 μmol/L for women). B. Correlation between Ccap(μmol/l) and Cpl(μmol/l) in men (n=80). The horizontal and vertical lines represent the threshold for definition of the true positive (i.e. 110 μmol/l for men).
Figure 2:
Figure 2:
Level of agreement between the Ccap and Cpl measurements (Bland-Altman plot). The dotted lines correspond to the mean [95%CI] for the difference between Ccap and Cpl.
Figure 3:
Figure 3:
Correlation between eGFRcap and eGFRpl (in ml/min/1.73m2). The vertical and horizontal red lines correspond to the threshold for the definition of kidney failure in each of the estimations (i.e. 60 ml/min/1.73m2).
Figure 4:
Figure 4:
Level of agreement between eGFRcap and eGFRpl (Bland-Altman plot). The dotted lines correspond to the mean [95%CI] for the difference between eGFRcap and eGFRpl).
See this image and copyright information in PMC

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