Limitations of compensated Jaffe creatinine assays in cirrhotic patients.

Abstract

OBJECTIVES:

This study aimed to evaluate the impact of two creatinine measurement methods on the Model for End Stage Liver Disease (MELD) score and glomerular filtration rate estimation (eGFR) in cirrhotic patients. We focused on ID-MS traceable method such as compensated Jaffe (cJafCreat) and enzymatic (EnzCreat) methods.

DESIGN AND METHODS:

Potential protein-related interferences in creatinine determination were evaluated using dialysates spiked with albumin. MELD score, CKD-EPI formula creatinine-based eGFR and cystatin C-based eGFR were evaluated in 100 cirrhotic patients.

RESULTS:

In vitro model demonstrated that low protein levels result in an underestimation of creatinine levels using cJafCreat. In patients, cJafCreat created a negative bias of -6.1 μmol/L that led to higher eGFR and lower MELD scores.

CONCLUSIONS:

cJafCreat contributes to an overestimation of renal function in cirrhotic patients and may alter cirrhosis-severity assessment. Compensated Jaffe assays should therefore be replaced by enzymatic methods.

• Authors: Nils Kuster, Anne-Sophie Bargnoux, Georges-Philippe Pageaux, Jean-Paul Cristol
• Journal: Clinical biochemistry (Clin Biochem) Vol. 45 Issue 4-5 Pg. 320-5 (Mar 2012) ISSN: 1873-2933 [Electronic] United States
• PMID: 22178107 (Publication Type: Comparative Study, Evaluation Study, Journal Article)
• Copyright: Copyright © 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Chemical References

• CST3 protein, human
• Cystatin C
• Hemodialysis Solutions
• Creatinine
• Amidohydrolases
• creatininase

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Amidohydrolases (metabolism)
• Creatinine (analysis, blood, metabolism)
• Cystatin C (blood)
• End Stage Liver Disease (blood, metabolism, physiopathology)
• Female
• Glomerular Filtration Rate
• Hemodialysis Solutions (chemistry)
• Humans
• Indicator Dilution Techniques
• Liver Cirrhosis (blood, metabolism, physiopathology)
• Male
• Middle Aged
• Renal Insufficiency (etiology)
• Reproducibility of Results
• Severity of Illness Index
• Young Adult