Utility of Point-of-Care Creatinine devices in screening for chronic kidney disease- A community-based service evaluation study

Abstract Background Chronic Kidney Disease (CKD) is a significant public health problem globally. However, in sub-Saharan Africa, it is characterized by late diagnosis and limited access to laboratory-based serum creatinine testing, the gold standard for assessment. Point-of-care (POCr) creatinine testing offers a promising and rapid alternative for community-based screening in such resource-limited settings. This study aimed to evaluate the role of POCr creatinine testing for the early detection of CKD in a community-based population and assessment of test performance with comparison to conventional laboratory methods. Methods A cross-sectional, service evaluation study was conducted among 261 adults in a community in central Freetown. Participants were categorized into high-risk (with hypertension, diabetes, or age ≥ 65) and low-risk groups. Paired finger-prick (POC device: Eaglenos M432) and venous blood samples (laboratory Jaffe method) were collected for creatinine measurement. Urinary albumin was also determined using dipstick (clinitek immunoassay-based technique of measuring microalbumin by Siemens). Estimated glomerular filtration rate was calculated using Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI). Results The prevalence of CKD was estimated at 13% among the study participants, systemic hypertension was the most predominant risk factor identified. The POCr consistently underestimated the blood creatinine by a mean factor of 0.2mg/dl (17.7umol/l) but has a strong positive correlation (r = 0.9) with laboratory measured creatinine. Conclusion The prevalence of chronic kidney disease in this cohort is 13% using the POC device. The device underestimates but strongly correlates with lab measurements of creatinine and might be a very useful screening tool.