title: Chronic kidney disease prevalence in Rivas, Nicaragua: use of a field device for creatinine measurement.
abstract: OBJECTIVE
  An epidemic of chronic kidney disease (CKD) has been identified in Pacific coastal regions of Central America, and screening in the field in these low income countries remains logistically problematic. We tested the performance characteristics of a point of care creatinine analyzer compared to standardized serum creatinine measurements.
  
  
  METHODS
  Measurements were conducted in 100 persons from a local health center (n=34) and hospital (n=66) in Rivas, Nicaragua using both a point-of-care analyzer (StatSensor Xpress, Nova Biomedical) and serum creatinine by Jaffe kinetic method with a Roche Cobas Integra 400 analyzer. Percent coefficient of variation, sensitivity and specificity of the StatSensor Xpress were determined.
  
  
  RESULTS
  The average coefficient of variation (CV) was 1.28% for the serum creatinine and CV for the StatSensor Xpress analyzer was 6.8%. The median intra-individual creatinine results obtained with the StatSensor Xpress device were 0.32 mg/dL higher than those by serum creatinine by Jaffe kinetic method. The sensitivity and specificity of the StatSensor Xpress device for identifying subjects with abnormal creatinine (defined as >1.2 mg/dL) was 100% and 79%, respectively.
  
  
  CONCLUSIONS
  Point of care testing for creatinine demonstrated acceptable repeatability, excellent sensitivity (100%) and modest specificity (79%). Using the point of care testing will allow for generalized screening in the field in low income countries; however, confirmation for elevated levels >1.2 mg/dL will require a second laboratory test confirmation.
authors.affiliation: University of Toronto Faculty of Medicine, 1 King's College Circle, Toronto, ON M52 1A8, Canada. Electronic address: Kailey.minnings@mail.utoronto.ca.
authors.forename: Kailey
authors.initials: K
authors.lastname: Minnings
authors.affiliation: Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA. Electronic address: ekerns@lifespan.org.
authors.forename: Eric
authors.initials: E
authors.lastname: Kerns
authors.affiliation: Boston VA Healthcare System, 150 S. Huntington Avenue, Boston, MA 02458, USA. Electronic address: maf333@cornell.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Fiore
authors.affiliation: University of Massachusetts School of Medicine, 55 N. Lake Avenue, Worcester, MA 01655, USA. Electronic address: lynnefiore@gmail.com.
authors.forename: Madeline
authors.initials: M
authors.lastname: Fiore
authors.affiliation: Hospital for Sick Children, University Health Network, University of Toronto, 555 University Ave., Toronto, ON M5G 1X8, Canada. Electronic address: rulan.parekh@sickkids.ca.
authors.forename: Rulan S
authors.initials: RS
authors.lastname: Parekh
authors.affiliation: Nova Biomedical, 200 Prospect Street, Waltham, MA 02453, USA. Electronic address: jadubois@novabio.com.
authors.forename: Jeff
authors.initials: J
authors.lastname: DuBois
authors.affiliation: Saint Louis University School of Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104, USA. Electronic address: tscott.isbell@gmail.com.
authors.forename: T Scott
authors.initials: TS
authors.lastname: Isbell
authors.affiliation: Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA. Electronic address: rferg@bu.edu.
authors.forename: Ryan
authors.initials: R
authors.lastname: Ferguson
authors.affiliation: Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA. Electronic address: lfiore@bu.edu.
authors.forename: Louis
authors.initials: L
authors.lastname: Fiore
mesh_terms: D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D009527:Nicaragua / Q000453:epidemiology; D019095:Point-of-Care Systems; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D012680:Sensitivity and Specificity
chemical_list: D003404:Creatinine
keywords: Chronic kidney disease; Creatinine; Point of care testing