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Creatinine measurement on dry blood spot sample for chronic kidney disease screening
Alan Castro Azevedo E Silva1, Juan Fidel Bencomo Gómez2, Jocemir Ronaldo Lugon1
1Universidade Federal Fluminense, Brazil.
Insights
Screening for chronic kidney disease (CKD) is now simpler using a novel dry blood spot test to measure creatinine. This non-invasive method offers good accuracy for early detection of CKD.
Area of Science:
- Nephrology
- Clinical Chemistry
- Diagnostic Testing
Background:
- Chronic kidney disease (CKD) presents significant morbidity and mortality.
- Current screening methods involve blood and urine sampling.
- A simpler, more accessible screening method is needed.
Purpose of the Study:
- To introduce and evaluate a novel, simpler method for CKD screening.
- To measure creatinine levels using a dry blood spot on filter paper.
- To assess the feasibility and accuracy of this new diagnostic approach.
Main Methods:
- 106 high-risk individuals for CKD were enrolled.
- Creatinine was measured from dry blood spots.
- Estimated glomerular filtration rate (eGFR) was calculated using creatinine values.
- CKD diagnosis was based on an eGFR cutoff of < 60 ml/min.
Main Results:
- The study included 106 participants with a mean age of 57 years; 74% were female.
- High prevalence of risk factors: 76% hypertensive, 30% diabetic, 37% family history of CKD.
- Dry blood spot creatinine measurement showed high accuracy (90-92%) and sensitivity (94-96%) for CKD detection using MDRD and CKD-EPI equations.
- Bland and Altman analysis confirmed minimal systematic differences in creatinine values.
Conclusions:
- Measuring creatinine on dry blood samples is a feasible and non-invasive diagnostic test.
- This method demonstrates good accuracy for screening chronic kidney disease.
- The dry blood spot test offers a potentially valuable tool for early CKD detection.
Introduction:
Chronic kidney disease (CKD) screening is advisable due to its high morbidity and mortality and is usually performed by sampling blood and urine.
Objective:
Here we present an innovative and simpler method, by measuring creatinine on a dry blood spot on filter paper.
Methods:
One-hundred and six individuals at high risk for CKD were enrolled. The creatinine values obtained using both tests and the demographic data of each participant allowed us to determinate the eGFR. The adopted cutoff for CKD was an eGFR < 60 ml/min.
Results:
Mean age was 57 ± 12 years, 74% were female, 40% white, and 60% non-white. Seventy-six percent were hypertensive, 30% diabetic, 37% had family history of CKD, and 22% of smoking. The BMI was 29.5 ± 6.9 kg/m2, median systolic blood pressure was 125 mmHg (IQR 120-140 mmHg) and median diastolic blood pressure was 80 mmHg (IQR 70-80 mmHg). According to MDRD equation, sensitivity was 96%, specificity 55%, predictive positive value 96%, predictive negative value 55% and accuracy 92%. By the CKD-EPI equation the sensitivity was 94%, specificity 55%, predictive positive value 94%, predictive negative value 55% and accuracy 90%. A Bland and Altman analysis showed a relatively narrow range of creatinine values differences (+ 0.68mg/dl to -0.55mg/dl) inside the ± 1.96 SD, without systematic differences.
Conclusion:
Measurement of creatinine on dry blood sample is an easily feasible non-invasive diagnostic test with good accuracy that may be useful to screen chronic kidney disease.
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