CENTRAL ASIAN JOURNAL OF NEPHROLOGY
Original Article
Apr 27, 2026 10 2

Agreement Between Laboratory and Point-of-Care Creatinine–Based Risk Assessment for Post-Contrast Acute Kidney Injury in Patients Undergoing Urgent Angiography

Anara Abbay 1 * ,
Alimzhan Muxunov 2,
Doskhan Kozhakhmet 1,
Symbat Bayakhmetova 2,
Meruyert Madikenova 1,
Zhanat Kuanshaliyeva 3,
Yerlan Zhumagulov 4,
Marat Alikhanov 4,
Csaba P Kovesdy 5,
Abduzhappar Gaipov 1 3
1 Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan2 Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan3 Clinical-Academic Department of Internal Medicine, University Medical Center, Astana, Kazakhstan4 Angiography Laboratory, Multifield City Hospital #2, Astana, Kazakhstan5 Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA* Corresponding Author
Central Asian Journal of Nephrology, 2(2), 2026, cajn015, https://doi.org/10.63946/cajn/18482
Publication date: Apr 27, 2026
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ABSTRACT

Background: Rapid identification of patients at risk of contrast-associated acute kidney injury (AKI) is essential in acute settings such as acute myocardial infarction and ischemic stroke. Point-of-care (POC) creatinine testing provides immediate assessment of kidney function; however, its reliability for clinical risk stratification relative to standard laboratory measurements remains uncertain. This study evaluated the agreement between laboratory- and POC creatinine-based risk stratification and their association with subsequent AKI after contrast angiography.
Methods: In this prospective observational study, 295 adults undergoing contrast-enhanced angiography for acute myocardial infarction or acute ischemic stroke were enrolled. Serum creatinine was measured using both standard laboratory methods and a POC device before contrast administration. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI 2021 equation, and predicted risk of post-contrast AKI was assessed using the Mehran risk score. AKI was defined according to KDIGO criteria (≥1.5-fold increase from baseline or ≥26.5 µmol/L increase within 7 days). Agreement between laboratory- and POC-derived risk categories was evaluated using weighted Cohen’s kappa.
Results: The median age was 64 years (interquartile range 57–70), and 66.8% of participants were male. Based on laboratory measurements obtained in the hospital central laboratory, categories were low in 8.8%, moderate in 37.3%, high in 25.4%, and very high in 28.5% of patients. Among patients with available follow-up creatinine measurements (n = 127), CA-AKI occurred in 11.0% (14/127). Agreement between laboratory- and POC-based risk classifications was near-perfect (κ = 0.97, 95% CI 0.95–0.98). The correlation between laboratory and POC creatinine values was moderate (r = 0.63, p < 0.001).
Conclusion: POC creatinine–based Mehran risk stratification shows excellent diagnostic agreement with laboratory-based assessment for identifying patients at risk of post-contrast AKI. POC testing may facilitate rapid bedside risk assessment in patients undergoing angiography for acute myocardial infarction or ischemic stroke without compromising risk classification reliability.

KEYWORDS

Contrast-Associated Acute Kidney Injury Point-of-Care Testing Creatinine Mehran Risk Score Percutaneous Coronary Intervention Angiography Chronic Kidney Disease

CITATION (Vancouver)

Abbay A, Muxunov A, Kozhakhmet D, Bayakhmetova S, Madikenova M, Kuanshaliyeva Z, et al. Agreement Between Laboratory and Point-of-Care Creatinine–Based Risk Assessment for Post-Contrast Acute Kidney Injury in Patients Undergoing Urgent Angiography. Central Asian Journal of Nephrology. 2026;2(2):cajn015. https://doi.org/10.63946/cajn/18482
APA
Abbay, A., Muxunov, A., Kozhakhmet, D., Bayakhmetova, S., Madikenova, M., Kuanshaliyeva, Z., Zhumagulov, Y., Alikhanov, M., Kovesdy, C. P., & Gaipov, A. (2026). Agreement Between Laboratory and Point-of-Care Creatinine–Based Risk Assessment for Post-Contrast Acute Kidney Injury in Patients Undergoing Urgent Angiography. Central Asian Journal of Nephrology, 2(2), cajn015. https://doi.org/10.63946/cajn/18482
Harvard
Abbay, A., Muxunov, A., Kozhakhmet, D., Bayakhmetova, S., Madikenova, M., Kuanshaliyeva, Z., . . . Gaipov, A. (2026). Agreement Between Laboratory and Point-of-Care Creatinine–Based Risk Assessment for Post-Contrast Acute Kidney Injury in Patients Undergoing Urgent Angiography. Central Asian Journal of Nephrology, 2(2), cajn015. https://doi.org/10.63946/cajn/18482
AMA
Abbay A, Muxunov A, Kozhakhmet D, et al. Agreement Between Laboratory and Point-of-Care Creatinine–Based Risk Assessment for Post-Contrast Acute Kidney Injury in Patients Undergoing Urgent Angiography. Central Asian Journal of Nephrology. 2026;2(2), cajn015. https://doi.org/10.63946/cajn/18482
Chicago
Abbay, Anara, Alimzhan Muxunov, Doskhan Kozhakhmet, Symbat Bayakhmetova, Meruyert Madikenova, Zhanat Kuanshaliyeva, Yerlan Zhumagulov, Marat Alikhanov, Csaba P Kovesdy, and Abduzhappar Gaipov. "Agreement Between Laboratory and Point-of-Care Creatinine–Based Risk Assessment for Post-Contrast Acute Kidney Injury in Patients Undergoing Urgent Angiography". Central Asian Journal of Nephrology 2026 2 no. 2 (2026): cajn015. https://doi.org/10.63946/cajn/18482
MLA
Abbay, Anara et al. "Agreement Between Laboratory and Point-of-Care Creatinine–Based Risk Assessment for Post-Contrast Acute Kidney Injury in Patients Undergoing Urgent Angiography". Central Asian Journal of Nephrology, vol. 2, no. 2, 2026, cajn015. https://doi.org/10.63946/cajn/18482

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