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Evaluating the Utility of Rapid Point-of-Care Potassium Testing for the Early Identification of Hyperkalemia in Patients with Chronic Kidney Disease in the Emergency Department

Authors
 Je Sung You  ;  Yoo Seok Park  ;  Hyun Soo Chung  ;  Hye Sun Lee  ;  Youngseon Joo  ;  Jong Woo Park  ;  Sung Phil Chung  ;  Shin Ho Lee  ;  Hahn Shick Lee 
Citation
 YONSEI MEDICAL JOURNAL, Vol.55(5) : 1348-1353, 2014 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2014
MeSH
Blood Chemical Analysis/methods ; Emergency Service, Hospital ; Humans ; Hyperkalemia/diagnosis* ; Point-of-Care Systems ; Potassium/blood* ; Renal Insufficiency, Chronic/blood* ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity
Keywords
Point-of-care testing ; chronic kidney disease ; hyperkalemia
Abstract
PURPOSE: Severe hyperkalemia leads to significant morbidity and mortality if it is not immediately recognized and treated. The concentration of potassium (K⁺) in the serum increases along with deteriorating renal function. The use of point-of-care K⁺ (POC-K⁺) in chronic kidney disease (CKD) could reduce the time for an accurate diagnosis and treatment, saving lives. We hypothesized that POC-K⁺ would accurately report K⁺ serum level without significant differences compared to reference testing, regardless of the renal function of the patient. MATERIALS AND METHODS: The retrospective study was performed between January 2008 and September 2011 at an urban hospital in Seoul. The screening program using POC was conducted as a critical pathway for rapid evaluation and treatment of hyperkalemia since 2008. When a patient with CKD had at least one warning symptom or sign of hyperkalemia, both POC-K⁺ and routine laboratory tests were simultaneously ordered. The reliability of the two assays for serum-creatinine was assessed by intra-class correlation coefficient (ICC) analysis using absolute agreement of two-way mixed model. RESULTS: High levels of reliability were found between POC and the laboratory reference tests for K⁺ (ICC=0.913, 95% CI 0.903-0.922) and between two tests for K⁺ according to changes in the serum-creatinine levels in CKD patients. CONCLUSION: The results of POC-K⁺ correlate well with values obtained from reference laboratory tests and coincide with changes in serum-creatinine of patients with CKD.
Files in This Item:
T201403838.pdf Download
DOI
10.3349/ymj.2014.55.5.1348
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hahn Shick(이한식)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Joo, Young Seon(주영선)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100252
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