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Albuminuria, commonly measured as urine albumin-to-creatinine ratio (ACR), is an under-recognized component of chronic kidney disease (CKD) definition, staging and prognosis.
Albuminuria, elevated serum creatinine and low estimated glomerular filtration rate (eGFR) are key indicators of kidney decline. However, it is unclear if these biomarkers are independent predictors of kidney disease progression in people with type 2 diabetes mellitus (T2DM).
ACR and eGFR as predictors of cardio-renal outcomes in diabetes and kidney disease
Diabetic kidney disease, and chronic kidney disease attributed to diabetes, occurs in 20-40% of patients with diabetes. Acute kidney injury is also one of the most significant complications associated with COVID-19. Point-of-care testing for albumin-creatinine ratio is a valuable tool for monitoring at-risk patients, especially in combination with other comorbid parameters, such as HbA1c and lipids.
ACR point-of-care testing for diabetic kidney disease
In this Q&A article, we look at some key questions healthcare professionals may have about point-of-care testing (POCT). We cover how POCT can be of value within specific clinical fields and in clinicians’ day-to-day roles, including discussion of how POCT may contribute to faster results, greater flexibility for patients and reduced antibiotic prescribing.
In our feature article series, we take a look at publications of particular relevance to point-of-care testing (POCT), providing summaries and expert commentary on the key aspects of the paper and within the wider context of POCT systems.In this article, we cover the below publication by Professor Cooke and co-authors
Respiratory tract infections in primary care: narrative review of CRP point-of-care testing and antibacterial use
In our feature article series, we take a look at publications of particular relevance to point-of-care testing (POCT), providing summaries and expert commentary on the key aspects of the paper and within the wider context of POCT systems.
Point-of-care testing to improve cost-effectiveness of health check programmes in primary care
Health Information and Quality Authority (HIQA), published online April 2019This health technology assessment (HTA) aimed to establish the clinical and cost-effectiveness of CRP POCT, plus examined the organisational implications of the potential introduction of the technology into primary care. A summary of key findings is provided below:
Health Technology Assessment of CRP POCT to guide antibiotic prescribing for acute respiratory tract infections in primary care settings
European Network for Health Technology Assessment (EUnetHTA), published online January 2019This collaborative assessment on C-reactive protein (CRP) point-of-care testing (POCT) aims to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs). The assessment sought to answer three questions by conducting three separate systematic reviews:
C-reactive protein POCT to guide antibiotic prescribing in primary care settings for acute respiratory tract infections
Jan Verbakel, Joseph Lee, Clare Goyder, Pui San Tan, Thanusha Ananthakumar, Philip Turner, Gail Hayward, and Ann Van den BruelBMJ Open, 2019The aim of this review was to collate all available evidence on the impact of C-reactive protein (CRP) point-of-care testing (POCT) on patient-relevant outcomes in children and adults in ambulatory care.
Impact of CRP POC testing in ambulatory care: a systematic review and meta-analysis
Erna Lenters-Westra, and Emma EnglishJournal of Diabetes Science and Technology 2018;12(4):762-770Given the importance of point-of-care testing (POCT) in healthcare delivery, Lenters-Westra and English investigate the quality criteria used to evaluate POCT devices to establish whether these perform to the same standard as main laboratory analysers. They apply the Clinical and Laboratory Standards Institute (CLSI) protocols EP-5 and EP-9 to evalua...
Evaluation of four HbA1c POC devices using international quality targets: are they fit for the purpose?
The EurA1c Trial GroupClinical Chemistry 2018;64(8):1183-1192The aim of this extensive study was to generate awareness and improvement of HbA1c assays through evaluation of performance by countries and by manufacturers. Analytical performance of 2166 laboratories were evaluated across 17 countries and 24 manufacturers, of which 22 were laboratory systems and two were point-of-care (POC) systems, according to International Federation of Clinical C...
EurA1c: the European HbA1c trial to investigate the performance of HbA1c assays
NGSP and the College of American Pathologists (CAP), 2020The American Diabetes Association (ADA) recommends that HbA1c tests should be performed using a method that is certified by NGSP. Participation in a proficiency testing survey (external quality assessment), such as the CAP GH5 fresh whole blood HbA1c program, allows individual laboratories to compare their performance against peer groups and against the target values assigned by NGSP.
GH5 proficiency survey data for standardisation of HbA1c testing
Erna Lenters-Westra and Emma EnglishJournal of Diabetes Science and Technology 2019;13(6):1154-1157Lenters-Westra and English consider the pros and cons of different methods for evaluating the performance of HbA1c point-of-care testing (POCT) devices, including:
Investigating the quality of POCT devices for HbA1c: what are our next steps?
Vincent Delatour, Noémie Clouet-Foraisona, Stéphane Jaisson, Patricia Kaiser and Philippe GilleryClinical Chemistry and Laboratory Medicine 2019;25(57)10:1623-1631In this article Delatour and co-authors explore the trueness of external quality assessment (EQA) programmes for determining accuracy of HbA1c testing in diabetes (both lab-based and point-of-care systems). Commutability of processed EQA materials was found to be highly heterogeneous an...
Trueness assessment of HbA1c routine assays: are processed EQA materials up to the job?
An international expert panel discusses POCT related to COVID-19 severity assessment and risk prediction, plus covers the role of POCT in antimicrobial resistance during the pandemic, in this video seminar originally delivered live on 4 September 2020. Hear from Professor Nicholas Francis (UK), Professor Ivan Gentile (Italy), Dr Carl Llor (Spain), Professor Dag Berild (Norway) and Dr Aggy York (UK) by clicking here.
Hear expert opinion on the use of CRP POCT for COVID-19 management and reduction of antimicrobial resistance
Check out the on-demand educational recording from Africa Online Healthcare Week 2020 by clicking here. Dr Susanne Emmerich (Germany) discusses the relationship between diabetes and COVID-19, and how HbA1c point-of-care testing (POCT) impacts glycemic control in diabetic patients. Dr Carl Llor (Spain) discusses the value of C-reactive protein (CRP) POCT to aid assessment of COVID-19 and prevent unnecessary prescription of antibiotics.
View expert presentation on point-of-care testing for diabetes and in the context of COVID-19
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