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Kidney Week

Abstract: PO2422

Point-of-Care Creatinine Self-Testing in Renal Transplant Patients: An Assessment of Accuracy, Precision, and Patient Experience

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Fernandes da Costa, Fabiana, Imperial College NHS TRUST, London, United Kingdom
  • Willicombe, Michelle, Imperial College NHS TRUST, London, United Kingdom
  • Bramham, Kate, Department of Women and Children’s Health, King's College London, London, London, United Kingdom
  • Kelly, Clare B., Department of Women and Children’s Health, King's College London, London, London, United Kingdom
Background

During the Covid-19 pandemic it has become increasingly important to provide virtual care for patients with CKD. Point-of-Care testing of capillary creatinine (POC-Cr) is now available and has demonstrated validity, ease of use, improved efficiency and cost-efficiency. We aimed to determine patients’ desire to self-monitoring of POC-Cr and their characteristics.

Methods

Renal transplant patients were shown how to perform self-POC-Cr testing with a NovaBio StatSensor®Xpress device, then undertook a test independently and answered survey questions about their attitude to self-testing of POC-Cr.

Results

All patients (N=189; Median age 52 years (IQR 40,64) ; 44 (23%) English as a second language; 128 (68%) male; Median eGFR 49 mls/min/1.73m2 (IQR 34,64) successfully performed a POC-Cr test and 110/120 (91%) of patients who completed the survey reported they would like to self-monitor POC-Cr. Most patients wished to reduce their clinic attendance and the majority were willing to have telephone consultations. Characteristics of the cohort are described in Table 1.

Conclusion

All transplant patients successfully performed a POC-Cr test with written instructions and a demonstration. Most patients would like to self-monitor POC-Cr and reduce clinic attendance. Limitations include the single-centre design, number of participants and language barrier. Virtual care including patient self-monitoring using POC-Cr should be explored.

Characteristics of patients who would and would not like to self-monitor POC-Cr at home
CharacteristicsWould like to self-monitor POC-Cr at home
N=110
Would not like to perform testing at home
N=10
Male, n (%)76 (69%)5 (50%)
Age (Years Median (IQR))54 (41, 64)55 (40, 61)
English as Second Language40 / 109 (37%)2 (20%)
Educational level n (%)
Primary School
Secondary School
Higher education
5 / 77 (6%)
25 / 77 (32%)
47 / 77 (61%)

1 / 9 (11%)
3 / 9 (33%)
5 / 9 (56%)
First Year post transplant41 (37%)5 (50%)
Ethnicity
White
Black
Asian
Other
40 (36%)
16 (14%)
38 (34%)
16 (14%)
1 (10%)
1 (10%)
7 (70%)*
1 (10%)
eGFR (mls/min/1.73m2
Median (IQR))
50 (38, 63)50 (24, 72)
After single test in clinic felt able to perform at home104 /108 (96%)6 (60%)**
Able to check blood pressure at home99 /107 (93%)9 /9 (100%)
Access to an email address100 (91%) 7 (70%)
Access to a smartphone or a computer105 (95%)7 (70%)#
Has Remote Access to Laboratory Results96 (87%) 5 (50%)##
Would like to reduce attendance at clinic85 /106 (80%)7 (70%)
Would be willing to have telephone consultations104 (95%)7 (70%)$
Would be willing to have video consultations82 (75%)5 (50%)