Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice.
Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice.
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DOI：
10.5334/aogh.3884
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发表时间：
2023
影响因子：
2.9
通讯作者：
Brooks DR
中科院分区：
文献类型：
--
作者：
Dally M;Amador JJ;Butler-Dawson J;Lopez-Pilarte D;Gero A;Krisher L;Cruz A;Pilloni D;Kupferman J;Friedman DJ;Griffin BR;Newman LS;Brooks DR
随着非传统来源的慢性肾病（CKDnt）在低资源环境中的患病率上升，有必要进行可靠的即时肌酸酐检测。本分析的目的是评估两种常用的即时肌酸酐装置的准确性，即i-STAT手持式（Abbott, Princeton， NJ， USA）和StatSensor肌酸酐（Nova Biomedical, Waltham， MA， USA）与静脉穿刺血清肌酸酐测量方法的比较。还介绍了每种设备的可负担性、灵敏度、特异性、易用性和其他考虑因素。对三个配对数据集进行比较。我们从2015-2016年尼加拉瓜的一项社区研究中收集了213对i-STAT和静脉穿刺样本。我们还收集了267个配对的StatSensor肌酐和静脉穿刺样本，其中158个来自2014-2015年尼加拉瓜社区环境，109个来自2017-2018年危地马拉甘蔗工人队列。使用Pearson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。i-STAT表现最准确，高估肌酐0.07 mg/dL (95% CI: 0.02, 0.12)，无比例偏倚证据。StatSensor肌酐在低肌酐水平下表现良好（平均（SD）： 0.87(0.19)）。由于比例偏倚，StatSensor肌酐在尼加拉瓜社区环境中表现较差，肌酐值范围为0.31至7.04 mg/dL。两种设备都提供可接受的灵敏度和特异性。虽然对于常规监测是足够的，但StatSensor肌酐随着测量肌酐值的增加而不太准确，这是使用即时护理设备筛查CKDnt风险个体时的一个考虑因素。在选择定点肌酸酐装置时，必须仔细考虑研究、临床和筛查目标、成本、易用性和疾病背景患病率。在资源有限的环境中，POC测试更容易实现。选择合适的设备将取决于用例。
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. 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. 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. 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. 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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影响因子：
8.1
作者：
George C;Mogueo A;Okpechi I;Echouffo-Tcheugui JB;Kengne AP
通讯作者：
Kengne AP
影响因子：
2.3
作者：
Figueroa-Solis E;Gimeno Ruiz de Porras D;Delclos GL
通讯作者：
Delclos GL
影响因子：
5
作者：
van der Heijden, Catharina;Roosens, Laurence;Peeters, Bart
通讯作者：
Peeters, Bart
影响因子：
2.8
作者：
Minnings, Kailey;Kerns, Eric;Fiore, Louis
通讯作者：
Fiore, Louis
DOI：
10.1016/s0140-6736(18)32335-3
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 DALYs and HALE Collaborators
通讯作者：
GBD 2017 DALYs and HALE Collaborators