Pilot study determining the feasibility of implementing the Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol, point-of-care field measurements and a new module on risk factors for chronic kidney disease of unknown origin in Hispanic outdoor workers

Abstract Background To field test the Disadvantaged Populations eGFR Epidemiology (DEGREE) protocol, outdoor point-of-care (POC) testing for serum creatinine, and a new risk factor module on chronic kidney disease of undetermined origin (CKDu) in U.S. outdoor Hispanic workers. Methods Fifty workers were interviewed in Houston (TX). DEGREE and CKDu questionnaires were completed indoors. Anthropometrics and paired blood samples for POC and laboratory assay were completed outdoors over two periods (November–December 2017, April–May 2018). Results Administration of DEGREE and CKDu questionnaires averaged 10 and 5 min, respectively, with all questions easily understood. We observed high correlations between POC and IDMS creatinine (r = 0.919) and BUN (r = 0.974). The POC device would disable testing when outdoor temperatures were above 85 °F or below 65 °F; this was adjustable. Conclusions Implementation of DEGREE and the new CKDu module was straightforward and well understood. The POC device performed well in the field, with some adjustment in methods when temperature readings were out of range.

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A smartphone-based point-of-care quantitative urinalysis device for chronic kidney disease patients

Journal of Network and Computer Applications ◽

10.1016/j.jnca.2018.04.012 ◽

2018 ◽

Vol 115 ◽

pp. 59-69 ◽

Cited By ~ 11

Author(s):

Shaymaa Akraa ◽

Anh Pham Tran Tam ◽

Haifeng Shen ◽

Youhong Tang ◽

Ben Zhong Tang ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Point Of Care

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Ethnicity and Chronic Kidney Disease in Disadvantaged Populations—An International Perspective

Chronic Renal Disease ◽

10.1016/b978-0-12-815876-0.00009-7 ◽

2020 ◽

pp. 121-138

Author(s):

Ricardo Correa-Rotter ◽

Guillermo García-García ◽

Jonathan Chávez-Iñiguez ◽

Juan C. Ramírez-Sandoval

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

International Perspective ◽

Disadvantaged Populations

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Performance of StatSensor Point-of-Care Device for Measuring Creatinine in Patients With Chronic Kidney Disease and Postkidney Transplantation

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120970716 ◽

2020 ◽

Vol 7 ◽

pp. 205435812097071

Author(s):

Melissa Nataatmadja ◽

Angela W. S. Fung ◽

Beryl Jacobson ◽

Jack Ferera ◽

Eva Bernstein ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Whole Blood ◽

Point Of Care ◽

Reference Method ◽

Plasma Creatinine ◽

Altman Analysis ◽

Bland Altman Analysis ◽

Deming Regression ◽

Ckd Stage

Background: The StatSensor is a point-of-care device which measures creatinine in capillary whole blood. Previous studies reported an underestimation of the creatinine measurements at high creatinine concentrations and were performed in the prestandardization era for creatinine. Objective: This accuracy-based study evaluates the use of this device in kidney-transplanted patients and those with chronic kidney disease (CKD). Design: Cross-sectional diagnostic accuracy study. Setting: Nephrology outpatient clinic in an urban tertiary center. Participants: Adults with CKD or a functioning kidney transplant. Measurements: Duplicate StatSensor creatinine measurements were performed on capillary whole blood samples collected by direct fingerstick and SAFE-T-FILL collection device. Results were compared with simultaneous venous blood sampling for serum and plasma creatinine measured by an enzymatic method on the Roche Integra 400 mainframe analyzer with traceability to the ID-GC-MS (isotope dilution gas chromatography mass spectrometry) reference method. Methods: Deming regression, Pearson correlation coefficient, and Bland-Altman analysis were used to assess accuracy and comparability between capillary whole blood measured by StatSensor and plasma creatinine measured by routine analyzer with traceability to the reference method. Estimated glomerular filtration (eGFR) rates were calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and concordance with Kidney Disease Improving Global Outcomes (KDIGO) CKD stage classification was evaluated. Results: There were 60 participants (mean age = 61.9 ± 15.0 years, 55% men, 33% transplant, mean plasma creatinine = 137 ± 59 µmol/L). Bland-Altman analysis indicated a positive mean bias of 12.7 µmol/L between StatSensor fingerstick creatinine measurement and plasma creatinine. Comparison of eGFR (CKD-EPI) calculated from the StatSensor fingerstick creatinine versus plasma creatinine showed misclassification across all KDIGO CKD stages. Postanalytical correction of the bias did not improve misclassifications. The use of mean of duplicate StatSensor creatinine results did not improve performance compared with the use of singlet results. Limitations: Single center, limited participant numbers. Conclusions: The results of our study suggest that the limiting characteristics of the StatSensor device are not only bias, but also imprecision. The level of imprecision observed may influence clinical decision-making and limit the usefulness of StatSensor as a CKD screening tool. If choosing to utilize it for either screening for or monitoring CKD, it is essential that clinicians understand the limitations of point-of-care devices and apply this knowledge to test interpretation.

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Chronic kidney disease in disadvantaged populations

Pediatric Nephrology ◽

10.1007/s00467-014-2996-z ◽

2014 ◽

Vol 30 (2) ◽

pp. 183-187 ◽

Cited By ~ 4

Author(s):

Guillermo Garcia-Garcia ◽

◽

Vivekanand Jha

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Disadvantaged Populations

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Chronic Kidney Disease in Disadvantaged Populations

Nephron Clinical Practice ◽

10.1159/000369148 ◽

2015 ◽

Vol 128 (3-4) ◽

pp. 292-296 ◽

Cited By ~ 2

Author(s):

Guillermo Garcia-Garcia ◽

Vivekand Jha ◽

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Disadvantaged Populations

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Clinical profile of chronic kidney disease of unknown origin in patients of Yavatmal district, Maharashtra, India

Journal of Renal Endocrinology ◽

10.34172/jre.2021.01 ◽

2020 ◽

Vol 7 (1) ◽

pp. e01-e01

Author(s):

Dhananjay Ookalkar ◽

Ashwini Ookalkar ◽

V.L. Gupta ◽

Manish R Balwani

Keyword(s):

Chronic Kidney Disease ◽

Renal Failure ◽

Kidney Disease ◽

Case Series ◽

Unknown Origin ◽

Geographic Area ◽

Epidemiological Survey ◽

Unknown Etiology ◽

Agricultural Communities ◽

Economic Class

We present a case series of patients with chronic kidney disease of unknown etiology (CKDu) coming from a well-defined geographic area, Yavatmal, district of Maharashtra, in central of India. These patients presented with advanced renal failure, variable proteinuria, and bilateral hyperechoic kidneys, largely normotensive and belonged to poor economic class from agricultural communities. The study highlights the need for large epidemiological survey in Yavatmal region to detect patients with CKDu and investigate the possible etiology.

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SAT-135 CHRONIC KIDNEY DISEASE OF UNKNOWN ORIGIN IN A REFERRAL HOSPITAL IN PANAMA

Kidney International Reports ◽

10.1016/j.ekir.2020.02.144 ◽

2020 ◽

Vol 5 (3) ◽

pp. S57-S58

Author(s):

A. CARRILLO ◽

D. Rey Rodríguez

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Unknown Origin ◽

Referral Hospital

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Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120922617 ◽

2020 ◽

Vol 7 ◽

pp. 205435812092261

Author(s):

John Papastergiou ◽

Michelle Donnelly ◽

Wilson Li ◽

Robert D. Sindelar ◽

Bart van den Bemt

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

High Risk ◽

Kidney Disease ◽

Early Detection ◽

Point Of Care ◽

Screening System ◽

High Risk Patients ◽

Risk Patients

Background: Chronic kidney disease (CKD) is a condition presenting with long-term slow progression of structural and/or functional damage to the kidneys. Early detection is key to preventing complications and improving outcomes. Point-of-care estimated glomerular filtration rate (eGFR) screening technology allows for detection of abnormal kidney function in the community pharmacy setting. Objective: To evaluate the effectiveness of a community pharmacist-directed point-of-care screening program and to identify the prevalence of CKD in high-risk patients. Design: Quantitative observational. Setting: Four community pharmacies in British Columbia over a 6-month period. Patients: In all, 642 participants with at least one CKD risk factor were identified and screened. Mean age was 60 years and females accounted for 55% of the study population. Measurements: Serum creatinine was measured from peripheral blood using the HeathTab® screening system (Piccolo® Renal Function Panel with the Piccolo® blood chemistry analyzer). eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Methods: Patients provided a sample of peripheral blood via a self-administered finger-prick and analytical data to assess kidney function was reported including blood urea nitrogen (BUN), serum creatinine, and electrolytes by the HealthTab® screening system. Once results were available, the pharmacist conducted a comprehensive medication review with the patient and recommended certain follow-up actions if appropriate. Results: CKD risk factor included diabetes (30%), hypertension (45%), cardiovascular disease (12%), family history of kidney disease (13%), age over 55 years (68%), and an Aboriginal, Asian, South Asian, or African ethnic background (82%). A total of 11.5% of patients had eGFR values lower than 60 mL/min (abnormal renal function) and 34% had an eGFR between 60 and 89 mL/min (minimally reduced renal function). Overall pharmacists’ actions included blood pressure check (98%), education on CKD and risk factors (89%), medication review (72%), and physician follow-up (38%). Limitations included lack of follow-up beyond the 3-month study period prevented medical confirmation of CKD and limited the ability to quantify the impact of pharmacist interventions on the clinical outcomes of patients with low eGFR. Conclusion: These results illustrate the prevalence of abnormal renal function among undiagnosed, high-risk patients in the community. Pharmacists, as the most accessible healthcare practitioners, are ideally positioned to utilize novel point-of care technologies to improve access to CKD screening, facilitate follow-up, and increase awareness around the importance of early detection.

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