Unadjusted Point of Care Creatinine Results Overestimate Acute Kidney Injury Incidence During Field Testing in Guatemala

Details

• Personal Author:
  Butler-Dawson J ; Cruz A ; Dally M ; Griffin BR ; Johnson RJ ; Krisher L ; Newman, Lee S. ; Sorensen C ; Tenney L ; Weitzenkamp D
• Description:
  OBJECTIVE: Acute 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. METHODS: Blood 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. RESULTS: POC 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. CONCLUSIONS: POC 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. [Description provided by NIOSH]
• Subjects:
  Agriculture Blood Environmental Exposure Epidemiology Farmers Hematologic Tests Hot Temperature Occupational Health Race Factors Risk Assessment Risk Factors Safety Temperature Workload Workplace

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• Keywords:
  Agricultural Processes Agricultural Workers Blood Samples Climatic Factors Environmental Exposure Farm Workers Global Health Heat Exposure Hot Environments Humans Kidney Function Kidneys Racial Factors Risk Factors Temperature Effects Work Capacity Work Environment Workers

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• ISSN:
  1932-6203
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; OSHA Region 8
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  13
• Issue:
  9
• NIOSHTIC Number:
  nn:20055303
• Citation:
  PLoS One 2018 Sep; 13(9):e0204614
• Contact Point Address:
  Benjamin R. Griffin, Division of Renal Diseases and Hypertension/Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
• Email:
  Benjamin.Griffin@ucdenver.edu
• Federal Fiscal Year:
  2018
• NORA Priority Area:
  Manufacturing ; Mining
• Performing Organization:
  University of Colorado Denver, Aurora
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  PLoS One
• End Date:
  20260831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:aac76eb4f41fbd5c12211e2d475946f92200b92261aaf8f2520a39b0179fd73646d915e2dc0d917c94b680a218c73982f48c44ce82bb9f603fdd308145c030bd
• Download URL:
  https://stacks.cdc.gov/view/cdc/217640/cdc_217640_DS1.pdf
• File Type:
  [PDF - 1.69 MB ]