Keyword: Point-of-Care Test
2 results found.
Congress Abstract
Central Asian Journal of Nephrology, 2(2, Suppl. 1), 2026, cajn_A13, https://doi.org/10.63946/cajn/19510
ABSTRACT:
Background: Evidence on chronic kidney disease (CKD) in Central Asia remains limited, particularly for community-based detection using both kidney function and albuminuria. This study assessed the frequency of CKD markers among adults in three cities of Kazakhstan and examined whether point-of-care (POC) creatinine testing could support community screening.
Methods: Adults were recruited through community screening events in Astana, Ust-Kamenogorsk, and Turkestan. Laboratory serum creatinine was used to calculate eGFR with the CKD-EPI 2021 equation, and urine albumin-to-creatinine ratio (ACR) was measured to identify albuminuria. Participants were classified as having screening-detected CKD markers if eGFR was <60 mL/min/1.73 m² and/or ACR was ≥30 mg/g on a single assessment. Multivariable logistic regression was used to examine associated factors. Capillary POC creatinine was compared with laboratory creatinine, and its diagnostic performance for identifying eGFR <60 mL/min/1.73 m² was evaluated.
Results: Of 1,022 participants with complete laboratory kidney measurements, 100 (9.8%; 95% CI 8.1–11.8) had screening-detected CKD markers. Albuminuria was identified in 7.7%, while reduced eGFR was present in 3.4%. Among participants with CKD markers, 52.0% reported no previous awareness of abnormal kidney findings. Hypertension was associated with approximately twice the adjusted odds of CKD markers (aOR 2.05, 95% CI 1.24–3.41). POC and laboratory creatinine were available for 987 participants. POC creatinine exceeded laboratory values by an average of 18.5 µmol/L, with wide limits of agreement. For identifying laboratory-defined reduced eGFR, POC-derived eGFR had 84.4% sensitivity, 83.4% specificity, 14.5% positive predictive value, 99.4% negative predictive value, and an AUC of 0.919.
Conclusions: CKD markers were detected in roughly one in ten screened adults, and albuminuria accounted for a substantial proportion of identified abnormalities. The high proportion of previously unrecognized findings supports greater use of combined eGFR and ACR assessment in CKD case-finding. POC creatinine may be useful for triage because of its strong rule-out performance, but positive findings should be confirmed with standardized laboratory testing.
Methods: Adults were recruited through community screening events in Astana, Ust-Kamenogorsk, and Turkestan. Laboratory serum creatinine was used to calculate eGFR with the CKD-EPI 2021 equation, and urine albumin-to-creatinine ratio (ACR) was measured to identify albuminuria. Participants were classified as having screening-detected CKD markers if eGFR was <60 mL/min/1.73 m² and/or ACR was ≥30 mg/g on a single assessment. Multivariable logistic regression was used to examine associated factors. Capillary POC creatinine was compared with laboratory creatinine, and its diagnostic performance for identifying eGFR <60 mL/min/1.73 m² was evaluated.
Results: Of 1,022 participants with complete laboratory kidney measurements, 100 (9.8%; 95% CI 8.1–11.8) had screening-detected CKD markers. Albuminuria was identified in 7.7%, while reduced eGFR was present in 3.4%. Among participants with CKD markers, 52.0% reported no previous awareness of abnormal kidney findings. Hypertension was associated with approximately twice the adjusted odds of CKD markers (aOR 2.05, 95% CI 1.24–3.41). POC and laboratory creatinine were available for 987 participants. POC creatinine exceeded laboratory values by an average of 18.5 µmol/L, with wide limits of agreement. For identifying laboratory-defined reduced eGFR, POC-derived eGFR had 84.4% sensitivity, 83.4% specificity, 14.5% positive predictive value, 99.4% negative predictive value, and an AUC of 0.919.
Conclusions: CKD markers were detected in roughly one in ten screened adults, and albuminuria accounted for a substantial proportion of identified abnormalities. The high proportion of previously unrecognized findings supports greater use of combined eGFR and ACR assessment in CKD case-finding. POC creatinine may be useful for triage because of its strong rule-out performance, but positive findings should be confirmed with standardized laboratory testing.
Original Article
Central Asian Journal of Nephrology, 2(2), 2026, cajn015, https://doi.org/10.63946/cajn/18482
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.
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.