Journal article
Unadjusted point of care creatinine results overestimate acute kidney injury incidence during field testing in Guatemala
PloS one, Vol.13(9), e0204614
09/27/2018
DOI: 10.1371/journal.pone.0204614
PMCID: PMC6160126
PMID: 30261074
Abstract
Objective
Acute kidney injury (AKI) occurs at high rates among agricultural workers (12 +/- 33%) in tropical environments. Because of the remote locations affected, traditional laboratory services are often unavailable. In this study we compare point of care (POC) creatinine values to standardized laboratory values, and examine the effect of POC testing on the interpretation of AKI rates under tropical field conditions.
Methods
Blood samples were collected from 104 sugarcane workers from two time points in January 2018 as a derivation cohort, and from 105 workers from February to April 2017 as a validation cohort. Finger stick and venipuncture samples were drawn at the end of a worker's shift to measure creatinine. Laboratory samples were tested in Guatemala City, Guatemala, in duplicate using the Jaffe Generation 2 method. An adjustment factor to improve agreement with serum creatinine was statistically derived and validated, and then used to determine impact on observed rates of acute kidney injury based on across shift changes in creatinine.
Results
POC creatinine and serum creatinine measures showed that POC consistently overestimated the creatinine by an average of 22% (95% CI: 19.8%, 24.7%) and the disagreement appeared greater at higher values of serum creatinine. An adjustment factor of 0.7775 was applied, which led to significantly greater agreement between the two measures. Rates of AKI in the two combined groups fell from 72% before adjustment to 57% afterwards.
Conclusions
POC testing under tropical field conditions routinely overestimates creatinine compared to laboratory testing, which leads to overestimation of rates of acute kidney injury. The application of an adjustment factor significantly improved the accuracy of the POC value.
Details
- Title: Subtitle
- Unadjusted point of care creatinine results overestimate acute kidney injury incidence during field testing in Guatemala
- Creators
- Benjamin R. Griffin - University of Colorado Anschutz Medical CampusJaime Butler-Dawson - Colorado School of Public HealthMiranda Dally - Colorado School of Public HealthLyndsay Krisher - Colorado School of Public HealthAlex Cruz - Pantaleon, Guatemala City, GuatemalaDavid Weitzenkamp - Colorado School of Public HealthCecilia Sorensen - University of Colorado DenverLiliana Tenney - Colorado School of Public HealthRichard J. Johnson - University of Colorado Anschutz Medical CampusLee S. Newman - Colorado School of Public Health
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.13(9), e0204614
- DOI
- 10.1371/journal.pone.0204614
- PMID
- 30261074
- PMCID
- PMC6160126
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- Public Library Science
- Number of pages
- 12
- Grant note
- U19OH011227 / NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA; National Institute for Occupational Safety & Health (NIOSH) R21 ES028826 / National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Pantaleon U19 OH01127 / Centers for Disease Control and Prevention (CDC); United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA CU Anschutz P30DK048520 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) R21ES028826 / NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Environmental Health Sciences (NIEHS)
- Language
- English
- Date published
- 09/27/2018
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984359942002771
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