White, Kyle C., Mccullough, James, Shekar, Kiran, Senthuran, Siva, Laupland, Kevin B., Dimeski, Goce, Serpa-Neto, Ary, Bellomo, Rinaldo, and Queensland Critical Care Research Network (QCRCN) (2024) Point-of-care creatinine vs. central laboratory creatinine in the critically ill. Critical Care and Resuscitation, 26 (3). pp. 198-203.

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Abstract

Objective: Frequent measurement of creatinine by point-of-care testing (POCT) may facilitate the earlier detection of acute kidney injury (AKI) in critically ill patients. However, no robust data exist to confirm its equivalence to central laboratory testing. We aimed to conduct a multicenter study to compare POCT with central laboratory creatinine (CrC) measurement.

Design: Retrospective observational study, using hospital electronic medical records. Obtained paired point-of-care creatinine (CrP) from arterial blood gas machines and CrC.

Setting: Four intensive care units in Queensland, Australia.

Participants: Critically ill patients, where greater than 50% of POCT contained creatinine.

Main outcome measures: Mean difference, bias, and limits of agreement between two methods, and biochemical confounders.

Results: We studied 79,767 paired measurements in 19,118 patients, with a median Acute Physiology and Chronic Health Evaluation 3 score of 51. The mean CrC was 115.5 μmol/L (standard deviation: 100.2) compared to a CrP mean of 115 μmol/L (standard deviation: 100.7) (Pearson coefficient of 0.99). The mean difference between CrP and CrC was 0.49 μmol/L with 95% limits of agreement of −27 μmol/L and +28 μmol/L. Several biochemical variables were independently associated with the difference between tests (e.g., pH, potassium, lactate, glucose, and bilirubin), but their impact was small.

Conclusion: In critically ill patients, measurement of creatinine by POCT yields clinically equivalent values to those obtained by central laboratory measurement and can be easily used for more frequent monitoring of kidney function in such patients. These findings open the door to the use of POCT for the earlier detection of acute kidney injury in critically ill patients.

Item ID:	85513
Item Type:	Article (Research - C1)
ISSN:	1441-2772
Copyright Information:	© 2024 The Authors. Published by Elsevier B.V. on behalf of College of Intensive Care Medicine of Australia and New Zealand. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Additional Information:	See PDF for full list of collaborators.
Date Deposited:	16 May 2025 00:04
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320207 Emergency medicine @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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