Self-testing kidney function gives accurate results, empowers patients and may save them and healthcare services time and money.

Problem

Patients with long-term conditions, such as heart failure, diabetes and chronic kidney disease, need regular tests to make sure their kidneys are functioning well and ensure that they are getting the right treatment. Currently this involves patients attending a specialist kidney clinic. We investigated the potential for patients to self-test their kidney function at home which could be more convenient. The project, led by Dr Jon Murray, involved collaboration with Abbott, South Tees Hospitals NHS Foundation Trust, the Academic Health Science Network for the North East and North Cumbria, NIHR Clinical Research Network for the North East and North Cumbria and Northern Counties Kidney Research Fund.

Action

• We investigated whether blood creatine and potassium measurements were consistent when using the Abbott i-STAT Alinity handheld device.
• The study assessed patients and nurses using the i-STAT and compared i-STAT readings with routine laboratory testing.
• The i-STAT device uses blood taken from a finger prick while the routine laboratory test uses blood taken from a vein.
• Therefore, we also monitored any differences in the readings that might be due to the sample type.
• We performed a rapid systematic review to compare our findings with published reports of similar studies.
• We also conducted interviews to gather the views of healthcare professionals and patients on using the test.

Outcome

• We found patients were able to use the Abbott i-STAT device as effectively as nurses in the clinic.
• The i-STAT results showed adequate agreement with laboratory test results.
• We noted expected differences in creatine and potassium readings between blood samples from a finger prick and a vein.
• Our findings are also consistent with previous reports examining the accuracy of the i-STAT device.
• Our interviews revealed that home monitoring improves the patient experience and could save NHS resources through reduced staff load and travel costs.

Impact

• The results have received mainstream media attention and have been summarised in a NIHRtv video.
• Future work could lead to updates to the care pathway for kidney function monitoring, providing both quality of life improvements for patients and cost savings for the NHS.
• By demonstrating that patients are able to self-test, this study opens up new possibilities for improving home monitoring and patient-centred care.

Read our Meet the MIC interview with Dr Cameron Williams where he discusses the outcomes of the research

For more details read our full publication