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Evaluation of a hand-held point-of-care analyser for measurement of creatinine in cats

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)207-215
Number of pages9
JournalJournal of Feline Medicine and Surgery
Volume19
Issue number2
Early online date23 Dec 2015
DOIs
DateAccepted/In press - 24 Nov 2015
DateE-pub ahead of print - 23 Dec 2015
DatePublished (current) - Feb 2017

Abstract

Objectives

The aim of the study was to evaluate whether a handheld creatinine analyser (StatSensor Xpress; SSXp), available for human patients, can be used to measure creatinine reliably in cats.

Methods

Analytical performance was evaluated by determining within- and between-run coefficient of variation (CV, %), total error observed (TEobs, %) and sigma metrics. Fifty client-owned cats presenting for investigation of clinical disease had creatinine measured simultaneously, using SSXp (whole blood and plasma) and a reference instrument (Konelab, serum); 48 paired samples were included in the study. Creatinine correlation between methodologies (SSXp vs Konelab) and sample types (SSXpwhole blood vs SSXpplasma) was assessed by Spearman’s correlation coefficient and agreement was determined using Bland–Altman difference plots. Each creatinine value was assigned an IRIS stage (1–4); correlation and agreement between Konelab and SSXp IRIS stages were evaluated.

Results

Within-run CV (4.23–8.85%), between-run CV (8.95–11.72%), TEobs (22.15–34.92%) and sigma metrics (⩽3) did not meet desired analytical requirements. Correlation between sample types was high (SSXpwhole blood vs SSXpplasma; r = 0.89), and between instruments was high (SSXpwhole blood vs Konelabserum; r = 0.85) to very high (SSXpplasma vs Konelabserum; r = 0.91). Konelab and SSXpwhole blood IRIS scores exhibited high correlation (r = 0.76). Packed cell volume did not significantly affect SSXp determination of creatinine. Bland–Altman difference plots identified a positive bias for the SSXp (7.13 μmol/l SSXpwhole blood; 20.23 μmol/l SSXpplasma) compared with the Konelab. Outliers (1/48 whole blood; 2/48 plasma) occurred exclusively at very high creatinine concentrations. The SSXp failed to identify 2/21 azotaemic cats.

Conclusions and relevance

Analytical performance of the SSXp in feline patients is not considered acceptable. The SSXp exhibited a high to very high correlation compared with the reference methodology but the two instruments cannot be used interchangeably. Improvements in the SSXp analytical performance are needed before its use can be recommended in feline clinical practice.

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