title: The usefulness of rapid point-of-care creatinine testing for the prevention of contrast-induced nephropathy in the emergency department.
abstract: 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.
  
  
  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.
authors: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Je Sung
authors: JS
authors: You
authors: Yong Eun
authors: YE
authors: Chung
authors: Jong Woo
authors: JW
authors: Park
authors: Woonhyoung
authors: W
authors: Lee
authors: Hye-Jeong
authors: HJ
authors: Lee
authors: Tae Nyoung
authors: TN
authors: Chung
authors: Sung Phil
authors: SP
authors: Chung
authors: Incheol
authors: I
authors: Park
authors: Seungho
authors: S
authors: Kim
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control*; D019985:Benchmarking; D019411:Clinical Laboratory Techniques; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000652:urine*; D004632:Emergency Medical Services; D019317:Evidence-Based Medicine; D006801:Humans; D007677:Kidney Function Tests; D019095:Point-of-Care Systems; D012015:Reference Standards; D012189:Retrospective Studies; D020521:Stroke / Q000652:urine; D013997:Time Factors
chemical_list: D003287:Contrast Media; D003404:Creatinine