Limitations of compensated Jaffe creatinine assays in cirrhotic patients

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• 作者：Nils Kuster^a ; ^b ; Anne-Sophie Bargnoux^a ; ^b ; Georges-Philippe Pageaux^c ; ^d ; Jean-Paul Cristol^a ; ^b ; ^{jp-cristol@chu-montpellier.fr}
• 关键词：MELD ; Model for End-Stage Liver Disease ; NKDEP ; National Kidney Disease Education Program ; ID-MS ; isotope dilution mass spectrometry ; eGFR ; estimated glomerular filtration rate ; cJafCreat ; compensated Jaffe creatinine ; EnzCreat ; enzymatic creatinine ; INR
• 刊名：Clinical Biochemistry
• 出版年：2012
• 期刊代码：55_00099120
• 类别：med
• 出版时间：March, 2012
• 卷：45
• 期：4-5
• 页码：320-325
• 文件大小：219 K

摘要

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 鈭?#xA0;6.1 渭mol/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.