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Hydroxyurea interferes with point-of-care creatinine testing in children with sickle cell anemia

Ruth Namazzi1, Robert O Opoka2, Charles Ssuuna3

  • 1Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.

BMC Research Notes
|June 19, 2026
PubMed

Insights

Hydroxyurea interferes with i-STAT creatinine tests in children with sickle cell anemia (SCA), potentially misdiagnosing kidney function. This interference impacts clinical decisions for SCA patients on hydroxyurea therapy.

Area of Science:

  • Pediatric Nephrology
  • Hematology
  • Clinical Diagnostics

Background:

  • Sickle cell anemia (SCA) affects children globally, requiring careful monitoring of kidney function.
  • Point-of-care testing offers rapid results but requires validation for specific patient populations and treatments.
  • Hydroxyurea is a common treatment for SCA, but its potential interference with diagnostic assays is a concern.

Purpose of the Study:

  • To assess the accuracy of the i-STAT device for creatinine measurement in Ugandan children with SCA.
  • To investigate the clinical significance of assay interference caused by hydroxyurea.

Main Methods:

  • Secondary analysis of a randomized clinical trial involving 248 Ugandan children with SCA.
  • Comparison of creatinine levels measured by i-STAT and a reference laboratory.
  • Correlation of i-STAT creatinine values with serum hydroxyurea concentrations.

Main Results:

  • i-STAT and reference lab creatinine values were comparable at baseline.
  • Children on hydroxyurea showed significantly higher i-STAT creatinine levels compared to reference lab values (p=0.006).
  • Hydroxyurea concentration explained 73% of the variability in i-STAT creatinine results.

Conclusions:

  • Hydroxyurea causes clinically significant interference with point-of-care creatinine testing using the i-STAT device.
  • This interference may lead to misclassification of kidney function in children with SCA receiving hydroxyurea.
  • Careful consideration of assay interference is crucial for appropriate clinical decision-making in this population.
Abstract

Keywords:
CreatinineDiagnostic accuracyHydroxyureaInterferencePoint-of-care testingSickle cell anemia

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