Table 1: Open in new tab KDIGO practice...

KDIGO practice point

Sensitivity (%)

Specificity (%)

Comments

Practice point 1.4.1

Whenever a POCT device is used for creatinine and urine albumin testing, ensure that the same pre-analytical, analytical and post-analytical quality criteria relating to the specimen collection and performance of the device, including external quality assessment, and the interpretation of the result is used

73.9 to 86.1 across the 3 best-performing devices for eGFR <30 mL/min/1.73 m² [29]

98.9 to 99.2, across the 3 best performing devices for eGFR <30 mL/min/1.73 m² [29]

Accuracy of the POCT devices has in general been deemed ‘acceptable’ but is variable. The accuracy appears greater at an eGFR <30 mL/min/1.73 m² but is lower at higher eGFR
POCT creatinine can be utilized to rapidly assess eGFR, in some cases generated automatically by the device. The caveat of accuracy must be considered, and the risk of inaccuracy should be carefully considered in the individual patient
Benefits and harms must be considered in the contexts of the available resources and the individual patient circumstances
Single values for creatinine and albuminuria should not be utilized to diagnose CKD, repeat testing is require for confirmation
Cost-effectiveness is largely unknown

Practice point 1.4.2

Where a POCT device for creatinine testing is being used, generate an estimate of GFR. Use the equation consistent with that used within the region

Practice point 1.4.3

Where a POCT device is being used for albuminuria testing, the capability of also analysing creatinine and producing an ACR is important. Assess the ability of the POCT ACR devices to produce a positive result in 85% of people with significant albuminuria (ACR ≥30 mg/g or ≥3 mg/mmol), as part of the evaluation and consideration of using the device

Semiquantitative test: 76 (95% CI 63–86);
quantitative test: 96 (95% CI 78–99) [28]

For uACR ≥30 mg/g (≥3 mg/mmol): 17.5–99.5
For uACR ≥30 mg/g (≥3 mg/mmol): 30–98.7
For uPCR >200 mg/g (>20 mg/mmol): 80.8–96.9
For uPCR >500 mg/g (>50 mg/mmol) 75.6–95.2
Semiquantitative test: 93 (95% CI 84–97)
Quantitative test: 99 (95% CI 93–99) [28]

Table 1:

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KDIGO practice points on POCT for kidney function.

	KDIGO practice point	Sensitivity (%)	Specificity (%)	Comments
Practice point 1.4.1	Whenever a POCT device is used for creatinine and urine albumin testing, ensure that the same pre-analytical, analytical and post-analytical quality criteria relating to the specimen collection and performance of the device, including external quality assessment, and the interpretation of the result is used	73.9 to 86.1 across the 3 best-performing devices for eGFR <30 mL/min/1.73 m² [29]	98.9 to 99.2, across the 3 best performing devices for eGFR <30 mL/min/1.73 m² [29]	Accuracy of the POCT devices has in general been deemed ‘acceptable’ but is variable. The accuracy appears greater at an eGFR <30 mL/min/1.73 m² but is lower at higher eGFR POCT creatinine can be utilized to rapidly assess eGFR, in some cases generated automatically by the device. The caveat of accuracy must be considered, and the risk of inaccuracy should be carefully considered in the individual patient Benefits and harms must be considered in the contexts of the available resources and the individual patient circumstances Single values for creatinine and albuminuria should not be utilized to diagnose CKD, repeat testing is require for confirmation Cost-effectiveness is largely unknown
Practice point 1.4.2	Where a POCT device for creatinine testing is being used, generate an estimate of GFR. Use the equation consistent with that used within the region
Practice point 1.4.3	Where a POCT device is being used for albuminuria testing, the capability of also analysing creatinine and producing an ACR is important. Assess the ability of the POCT ACR devices to produce a positive result in 85% of people with significant albuminuria (ACR ≥30 mg/g or ≥3 mg/mmol), as part of the evaluation and consideration of using the device	Semiquantitative test: 76 (95% CI 63–86); quantitative test: 96 (95% CI 78–99) [28]	For uACR ≥30 mg/g (≥3 mg/mmol): 17.5–99.5 For uACR ≥30 mg/g (≥3 mg/mmol): 30–98.7 For uPCR >200 mg/g (>20 mg/mmol): 80.8–96.9 For uPCR >500 mg/g (>50 mg/mmol) 75.6–95.2 Semiquantitative test: 93 (95% CI 84–97) Quantitative test: 99 (95% CI 93–99) [28]

	KDIGO practice point	Sensitivity (%)	Specificity (%)	Comments
Practice point 1.4.1	Whenever a POCT device is used for creatinine and urine albumin testing, ensure that the same pre-analytical, analytical and post-analytical quality criteria relating to the specimen collection and performance of the device, including external quality assessment, and the interpretation of the result is used	73.9 to 86.1 across the 3 best-performing devices for eGFR <30 mL/min/1.73 m² [29]	98.9 to 99.2, across the 3 best performing devices for eGFR <30 mL/min/1.73 m² [29]	Accuracy of the POCT devices has in general been deemed ‘acceptable’ but is variable. The accuracy appears greater at an eGFR <30 mL/min/1.73 m² but is lower at higher eGFR POCT creatinine can be utilized to rapidly assess eGFR, in some cases generated automatically by the device. The caveat of accuracy must be considered, and the risk of inaccuracy should be carefully considered in the individual patient Benefits and harms must be considered in the contexts of the available resources and the individual patient circumstances Single values for creatinine and albuminuria should not be utilized to diagnose CKD, repeat testing is require for confirmation Cost-effectiveness is largely unknown
Practice point 1.4.2	Where a POCT device for creatinine testing is being used, generate an estimate of GFR. Use the equation consistent with that used within the region
Practice point 1.4.3	Where a POCT device is being used for albuminuria testing, the capability of also analysing creatinine and producing an ACR is important. Assess the ability of the POCT ACR devices to produce a positive result in 85% of people with significant albuminuria (ACR ≥30 mg/g or ≥3 mg/mmol), as part of the evaluation and consideration of using the device	Semiquantitative test: 76 (95% CI 63–86); quantitative test: 96 (95% CI 78–99) [28]	For uACR ≥30 mg/g (≥3 mg/mmol): 17.5–99.5 For uACR ≥30 mg/g (≥3 mg/mmol): 30–98.7 For uPCR >200 mg/g (>20 mg/mmol): 80.8–96.9 For uPCR >500 mg/g (>50 mg/mmol) 75.6–95.2 Semiquantitative test: 93 (95% CI 84–97) Quantitative test: 99 (95% CI 93–99) [28]

CI, confidence intervals.

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