Impact of Albumin-to-Creatinine Ratio Point-of-Care Testing on the Diagnosis and Management of Diabetic Kidney Disease. (March 2023)

• Record Type: Journal Article
• Authors: Schultes, Bernd; Emmerich, Susanne; Kistler, Andreas D.; Mecheri, Badreddine; Schnell, Oliver; Rudofsky, Gottfried
• Is Part Of: Journal of diabetes science and technology. Volume 17:Number 2(2023)
• Page Start: 428
• Page End: 438
• Publication Date: 2023-03
• Subjects: albumin-to-creatinine ratio -- chronic kidney disease -- diabetes -- point-of-care testing; Diabetes -- Periodicals; Medical technology -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1177/19322968211054520
• Languages: English
• ISSNs: 1932-2968

Abstract

Background: For the diagnosis of diabetic kidney disease (DKD), quantitative albuminuria measurement using the albumin-to-creatinine ratio (ACR) is recommended according to various guidelines. It can be measured either in specialized laboratories or using ACR point-of-care testing (POCT). This observational study aims at evaluating the effect of ACR POCT utilization on the DKD diagnosis and treatment management for glycemic control and blood pressure. Method: Data of 717 patients with diabetes (type 1 diabetes: n = 236; type 2 diabetes: n = 463; other diabetes forms: n = 18) were assessed in three centers. The impact of ACR POCT on DKD diagnosis and treatment management for glycemic control and blood pressure was assessed using a case report form. The assessment of ACR POCT utilization purpose and relevance for physicians was documented using a questionnaire. Results: Of all participants (n = 717), 39.1% had a confirmed/suspected DKD diagnosis. Hereof, 8.6% were newly diagnosed with DKD, and 9.9% were suspected with DKD based on the actual ACR POCT values. Within the group of patients with confirmed/suspected DKD (n = 280), treatment modification was performed in 46.1% of participants. A drug initiation with GLP-1 receptor agonists or SGLT2 inhibitors was performed in 11.1% or 8.9% of patients with confirmed/suspected DKD, respectively. Regarding the utilization purposes of ACR POCT, 100% of the physicians (n = 8) indicated using it to examine patients with diabetes with or without hypertension; 75% considered it very important for patients with diabetes. Conclusions: The implementation of ACR POCT may positively affect DKD diagnosis and subsequently allow better management of patients with diabetes.