Peer-reviewed veterinary case report
Handheld creatinine meter tested for cat kidney checks
By Reeve, Jenny et al.·Published in Journal of feline medicine and surgery·2017·1 School of Veterinary Sciences, United Kingdom·View original on PubMed →
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Original publication title: Evaluation of a handheld point-of-care analyser for measurement of creatinine in cats.
- Species:
- cat
Plain-English summary
A group of 50 cats with health issues had their creatinine levels (a measure of kidney function) tested using a handheld device called the StatSensor Xpress, which is typically used for humans. While the device showed a good correlation with a standard laboratory test, it didn't meet the necessary accuracy standards for reliable use in cats. In fact, it missed detecting kidney problems in some cats and had a tendency to give higher readings than the lab test. As a result, veterinarians are advised to be cautious and not rely on this handheld device for diagnosing kidney issues in cats until its performance improves.
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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 (TE, %) 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 (SSXpvs SSXp) 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%), TE(22.15-34.92%) and sigma metrics (⩽3) did not meet desired analytical requirements. Correlation between sample types was high (SSXpvs SSXp; r = 0.89), and between instruments was high (SSXpvs Konelab; r = 0.85) to very high (SSXpvs Konelab; r = 0.91). Konelab and SSXpIRIS 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 SSXp; 20.23 μmol/l SSXp) 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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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/26701957/