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The usefulness of rapid point-of-care creatinine testing for the prevention of contrast-induced nephropathy in the emergency department

 Je Sung You  ;  Yong Eun Chung  ;  Jong Woo Park  ;  Woonhyoung Lee  ;  Hye-Jeong Lee  ;  Tae Nyoung Chung  ;  Sung Phil Chung  ;  Incheol Park  ;  Seungho Kim 
 EMERGENCY MEDICINE JOURNAL, Vol.30(7) : 555-558, 2013 
Journal Title
Issue Date
Acute Kidney Injury/chemically induced ; Acute Kidney Injury/prevention & control* ; Benchmarking ; Clinical Laboratory Techniques ; Contrast Media/adverse effects* ; Creatinine/urine* ; Emergency Medical Services* ; Evidence-Based Medicine ; Humans ; Kidney Function Tests ; Point-of-Care Systems* ; Reference Standards ; Retrospective Studies ; Stroke/urine ; Time Factors
Computed tomography ; contrast-induced nephropathy ; creatinine ; point-of-care testing
BACKGROUND: Renal dysfunction is the most important factor to consider when predicting a patient's risk of developing contrast-induced nephropathy (CIN). Measurement of creatinine (Cr) via rapid point-of-care blood urea nitrogen/creatinine testing (POCT-BUN/Cr) to determine CIN risk could potentially reduce the time required to achieve an accurate diagnosis and to initiate and complete treatment in the emergency department (ED). The aim of our study was to compare the results of POCT-BUN/Cr and reference laboratory tests for BUN and serum Cr. MATERIALS AND METHODS: A retrospective analysis of suspected stroke patients who presented between November 2009 and November 2010, and had BUN and Cr levels measured by POCT-BUN/Cr, and the reference laboratory tests performed with the blood sample which was transferred to the central laboratory by an air-shoot system. Two assays were conducted on the whole blood (POCT) and serum (reference) by trained technicians. The time interval from arrival at the ED to reporting of the results was assessed for both assays via a computerised physician order entry system. RESULTS: The mean standard deviation (SD) interval from arrival at the ED to reporting of the results was 11.4 (4.9) min for POCT-BUN/Cr and 46.8 (38.5) min for the serum reference laboratory tests (p<0.001). Intra-class correlation coefficient (ICC) analysis demonstrated a high level of agreement (the consistency agreement) between POCT and the serum reference tests for both BUN (ICC=0.914) and Cr (ICC=0.980). CONCLUSIONS: This study suggests that POCT-BUN/Cr results correlate well with those of serum reference tests in terms of BUN and Cr levels and, in turn, predicting CIN. POCT-BUN/Cr is easily performed with a rapid turnaround time, suggesting its use in the ED may have substantial clinical benefit.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Ho(김승호)
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
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