Is point of care renal function testing reliable screening pre-IV contrast administration?

Area of Science:

• Nephrology
• Radiology
• Medical Diagnostics

Background:

• Intravenous iodinated contrast agents are crucial for computed tomography (CT) imaging.
• A small risk of post-contrast acute kidney injury (PC-AKI) exists, particularly in patients with pre-existing renal dysfunction.
• Accurate assessment of renal function is vital before administering IV contrast to mitigate PC-AKI risk.

Purpose of the Study:

• To evaluate the accuracy of point-of-care (POC) devices for estimating renal function in patients undergoing radiological investigations.
• To determine if POC devices can reliably identify patients at risk for PC-AKI.
• To assess the potential of POC devices to improve workflow efficiency in radiology departments.

Main Methods:

• Two POC devices, Nova StatSensor and Abbott iSTAT, were compared against a laboratory standard (Beckman AU5800).
• Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI formula for all methods.
• Patients were stratified into high risk (eGFR < 30), moderate risk (eGFR 30-59), and low risk (eGFR ≥ 60) categories.

Main Results:

• A total of 186 patients were included in the study.
• Nova StatSensor showed an R² of 0.77 and coefficient of variation of 10.65%.
• Abbott iSTAT demonstrated an R² of 0.83 and coefficient of variation of 7.36%.
• POC devices did not miss any high-risk patients but occasionally underreported eGFR values.

Conclusions:

• POC devices demonstrate moderate accuracy in detecting renal impairment for patients undergoing radiological procedures.
• These devices can serve as effective screening tools for renal function assessment.
• Further laboratory confirmation is recommended for any low eGFR values obtained via POC devices.