ArticlePloS one2018
Unadjusted point of care creatinine results overestimate acute kidney injury incidence during field testing in Guatemala.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Point-of-care creatinine tests to assess kidney function for outpatients requiring contrast-enhanced CT imaging: systematic reviews and economic evaluation.Health technology assessment (Winchester, England) · 2020Pooled it
- Article
- Agreement between serum creatinine and fingerstick creatinine measurements in adult patients admitted to the emergency department.BMC emergency medicine · 2025Observational
- Implementation of multiparameter point-of-care testing devices for non-communicable diseases at primary healthcare level in Peru.BMC health services research · 2025Article
- Validation of Nova Stat Profile Prime Plus point-of-care testing for dialysis in South Africa.African journal of laboratory medicine · 2025Article
- Application and comparison of point-of-care devices for field evaluation of underlying health status of Guatemalan sugarcane workers.PLOS global public health · 2024Article
- Prevalence and Geographic Distribution of Self-Reported Chronic Kidney Disease and Potential Risk Factors in Central America.International journal of environmental research and public health · 2023Article
- Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice.Annals of global health · 2023Article
- Point-of-care biomarkers for prediction of kidney function trajectory among sugarcane cutters: a comparative test accuracy study.BMJ open · 2022Article
- Sugarcane Workweek Study: Risk Factors for Daily Changes in Creatinine.Kidney international reports · 2021Article
- Misdiagnosis in occupational and environmental medicine: a scoping review.Journal of occupational medicine and toxicology (London, England) · 2021Article
- Article
- Workplace Screening Identifies Clinically Significant and Potentially Reversible Kidney Injury in Heat-Exposed Sugarcane Workers.International journal of environmental research and public health · 2020Article
- Creatinine Fluctuations Forecast Cross-Harvest Kidney Function Decline Among Sugarcane Workers in Guatemala.Kidney international reports · 2020Article
- CKD Care and Research in Guatemala: Overview and Meeting Report.Kidney international reports · 2020Article
- Hydration Choices, Sugary Beverages, and Kidney Injury in Agricultural Workers in California.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2020Article
- Acute kidney injury and workload in a sample of California agricultural workers.American journal of industrial medicine · 2020Article
- Longitudinal trends in renal function among first time sugarcane harvesters in Guatemala.PloS one · 2020Article
- Evaluation of heat stress and cumulative incidence of acute kidney injury in sugarcane workers in Guatemala.International archives of occupational and environmental health · 2019Article
- Risk Factors and Mechanisms Underlying Cross-Shift Decline in Kidney Function in Guatemalan Sugarcane Workers.Journal of occupational and environmental medicine · 2019Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveAcute kidney injury (AKI) occurs at high rates among agricultural workers (12-33%) in tropical environments. Because of the remote locations affected, traditional laboratory services are often unavailable. In this study we compare point of care (POC) creatinine values to standardized laboratory values, and examine the effect of POC testing on the interpretation of AKI rates under tropical field conditions.
methodsBlood samples were collected from 104 sugarcane workers from two time points in January 2018 as a derivation cohort, and from 105 workers from February to April 2017 as a validation cohort. Finger stick and venipuncture samples were drawn at the end of a worker's shift to measure creatinine. Laboratory samples were tested in Guatemala City, Guatemala, in duplicate using the Jaffe Generation 2 method. An adjustment factor to improve agreement with serum creatinine was statistically derived and validated, and then used to determine impact on observed rates of acute kidney injury based on across shift changes in creatinine.
resultsPOC creatinine and serum creatinine measures showed that POC consistently overestimated the creatinine by an average of 22% (95% CI: 19.8%, 24.7%) and the disagreement appeared greater at higher values of serum creatinine. An adjustment factor of 0.7775 was applied, which led to significantly greater agreement between the two measures. Rates of AKI in the two combined groups fell from 72% before adjustment to 57% afterwards.
conclusionsPOC testing under tropical field conditions routinely overestimates creatinine compared to laboratory testing, which leads to overestimation of rates of acute kidney injury. The application of an adjustment factor significantly improved the accuracy of the POC value.
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