Impact of point-of-care creatinine monitoring on early detection of acute kidney injury in critical illness

  • Kaori TakaoriEmail author
  • Shigehiko Uchino
  • Masanori Takinami
Original Article



To assess the utility and accuracy of creatinine measurement using point-of-care (POC) blood gas analysis compared to standard laboratory assay and to assess the effectiveness of frequent creatinine monitoring using POC blood gas analysis with respect to early detection of acute kidney injury (AKI).


We performed a single center retrospective observational study in 398 patients admitted to the intensive care unit. We investigated the clinical concordance of creatinine values measured by POC blood gas analysis (Cr-BG) compared to those measured by laboratory assay (Cr-lab). We compared the time to reach AKI diagnosis according to the KDIGO criteria using Cr-BG (KD-BG) to the standard criteria using Cr-lab (KD-lab).


Cr-BG correlated well with Cr-lab for day 1 (n = 375, R2 = 0.98, p < 0.001) and during the whole study period (n = 1258, R2 = 0.99, p < 0.001). The KD-BG measurement allowed the identification of 6.3% more patients (60.6%) as AKI than the KD-lab measurement. Approximately one-third of the patients were staged as AKI using the KD-BG measurement more than 6 h earlier than that using the KD-lab measurement.


The KDIGO criteria using POC blood gas analysis were clinically useful. Frequent creatinine monitoring using POC analysis can allow an earlier detection of AKI.


Acute kidney injury Point-of-care Blood gas Creatinine Intensive care unit 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Italian Society of Nephrology 2019

Authors and Affiliations

  1. 1.Intensive Care Unit, Department of AnesthesiologyThe Jikei University School of MedicineTokyoJapan

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