Evaluating the Utility of Rapid Point-of-Care Potassium Testing for the Early Identification of Hyperkalemia in Patients with Chronic Kidney Disease in the Emergency Department.
10.3349/ymj.2014.55.5.1348
- Author:
Je Sung YOU
1
;
Yoo Seok PARK
;
Hyun Soo CHUNG
;
Hye Sun LEE
;
Youngseon JOO
;
Jong Woo PARK
;
Sung Phil CHUNG
;
Shin Ho LEE
;
Hahn Shick LEE
Author Information
1. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. emstar@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Point-of-care testing;
hyperkalemia;
chronic kidney disease
- MeSH:
Blood Chemical Analysis/methods;
Emergency Service, Hospital;
Humans;
Hyperkalemia/*diagnosis;
Point-of-Care Systems;
Potassium/*blood;
Renal Insufficiency, Chronic/*blood;
Reproducibility of Results;
Retrospective Studies;
Sensitivity and Specificity
- From:Yonsei Medical Journal
2014;55(5):1348-1353
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Severe hyperkalemia leads to significant morbidity and mortality if it is not immediately recognized and treated. The concentration of potassium (K+) in the serum increases along with deteriorating renal function. The use of point-of-care K+ (POC-K+) in chronic kidney disease (CKD) could reduce the time for an accurate diagnosis and treatment, saving lives. We hypothesized that POC-K+ would accurately report K+ serum level without significant differences compared to reference testing, regardless of the renal function of the patient. MATERIALS AND METHODS: The retrospective study was performed between January 2008 and September 2011 at an urban hospital in Seoul. The screening program using POC was conducted as a critical pathway for rapid evaluation and treatment of hyperkalemia since 2008. When a patient with CKD had at least one warning symptom or sign of hyperkalemia, both POC-K+ and routine laboratory tests were simultaneously ordered. The reliability of the two assays for serum-creatinine was assessed by intra-class correlation coefficient (ICC) analysis using absolute agreement of two-way mixed model. RESULTS: High levels of reliability were found between POC and the laboratory reference tests for K+ (ICC=0.913, 95% CI 0.903-0.922) and between two tests for K+ according to changes in the serum-creatinine levels in CKD patients. CONCLUSION: The results of POC-K+ correlate well with values obtained from reference laboratory tests and coincide with changes in serum-creatinine of patients with CKD.