![]() Subsequently, enzymatic methods have been developed in an attempt to reduce these inaccuracies, and have been found to be more accurate (3), and are replacing the picrate methods used in laboratories. There have been concerns over the accuracy of the picric acid method, as multiple compounds can interfere with the reaction, thus generating an inaccurate result. It is based upon the colour change that occurs when creatinine is mixed with picric acid in an alkaline solution. The Jaffe method was developed in the 19 th century and is traditionally used in hospital laboratories. Two of the principle methods of measuring creatinine in blood/serum/plasma are the Jaffe method (alkaline picrate method) and enzymatic methods. ![]() The other appliances, by virtue of their table-top design, would be better suited to a primary care setting. ![]() Despite this variation, all analysis times are far shorter than the time taken for conventional creatinine results generated by laboratory testing.īoth the Nova Statsensor and i-STAT are hand-held devices and could therefore be used in the home environment. The time taken to generate a result varies between 30 seconds (Nova Statsensor) and 12 minutes (Piccolo Xpress). The Nova Statsensor (Nova Biomedical, USA) requires only 1.2 microlitres of blood for analysis as such, fingerprick blood collection is sufficient. The devices analyse whole blood, serum, plasma, or a combination of these, and require very small sample volumes. The table in Appendix 1 provides an overview of the ten creatinine POC devices identified.Ĭreatinine POC devices allow rapid measurement of creatinine levels. Depending on significance of result, this may or may not be communicated to the patient by letter, telephone or in person.īenefits of POC creatinine testing: Rapid knowledge of renal function, facilitating referral of patients to secondary care (emergency department or clinic) if necessary. Results subsequently sent back to general practice typically within 24 hours. Speed and ease of testing may allow more frequent monitoring, and earlier detection and thus management of deteriorating renal function (2).ĭ) Detection of acute on chronic renal failure and acute kidney injury (AKI)Įxisting Technology: Blood samples sent from GP for analysis in local hospital laboratory. This might be particularly useful in patients with end stage renal failure requiring renal replacement therapy. Depending on significance of result, this may or may not be communicated to the patient by letter, telephone or in person.īenefits of creatinine POC testing: Rapid (within minutes) result of creatinine level allowing immediate feedback of result to patient.ī) Dose adjustment of prescribed medications in patients with renal impairment:Įxisting Technology: Typically, the most recent recorded renal function test is used to assist medication dose adjustment.īenefits of creatinine POC testing: Up-to-date renal function allowing immediate dose reduction of medications which require dose adjustment due to renal impairment if necessary (1).Įxisting Technology: Patients attend GP or hospital for blood tests to monitor renal function.īenefits of creatinine POC testing: Home testing would allow monitoring of renal function in comfort of own home. Results subsequently sent back to GP typically within 24 hours. Current Practice and Advantages over Existing Technology:Ī) Screening for CKD by detection of elevated creatinine levels:Įxisting Technology: Blood samples sent from General Practice (GP) for analysis in local hospital laboratory.
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