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A High-throughput Method for Measurement of Glomerular Filtration Rate in Conscious Mice
Published on: May 10, 2013
Prime time for enzymatic creatinine methods in pediatrics.
Christa M Cobbaert1, Henk Baadenhuijsen, Cas W Weykamp
1Department of Clinical Chemistry, Amphia Hospital, Breda. c.cobbaert@planet.nl
Clinical Chemistry
|January 27, 2009
Summary
Enzymatic creatinine assays are more specific than Jaffe assays, showing less interference from common substances like albumin and hemoglobin F. This makes enzymatic methods preferable for accurate kidney function evaluation, especially in pediatric patients.
Area of Science:
- Clinical Chemistry
- Biochemical Analysis
- Pediatric Nephrology
Background:
- The Jaffe (alkaline picrate) reaction for creatinine measurement is known for nonspecificity, with existing literature being outdated.
- Current Jaffe and enzymatic creatinine assays require updated specificity information.
- Accurate creatinine measurement is crucial for assessing kidney function, particularly in pediatric populations.
Purpose of the Study:
- To update the understanding of nonspecificity for current Jaffe and enzymatic creatinine assays.
- To quantify the interference of common substances (albumin, IgG, bilirubin, Hb F) on creatinine measurements.
- To compare the specificity of Jaffe and enzymatic methods in a real-world laboratory setting.
Main Methods:
- Serum pools were spiked with albumin, IgG, bilirubin, Hb A, and Hb F to simulate interfering substances.
- 35 laboratories analyzed samples using 14 different method-analyzer combinations (Jaffe and enzymatic).
- Interferent-related coefficient of variation (CV) was quantified using mixed ANOVA.
Main Results:
- Bilirubin and Hb A showed minimal interference (<10%) across most Jaffe and enzymatic methods.
- Jaffe methods exhibited significant interference from Hb F, albumin, and IgG, unlike enzymatic methods.
- Within-laboratory CVs for Jaffe methods ranged from 5.4%-27%, while enzymatic methods showed <4% CV.
Conclusions:
- Albumin, IgG, and Hb F significantly interfere with Jaffe creatinine assays, impacting estimated glomerular filtration rates (eGFR).
- Enzymatic creatinine methods are not affected by protein error or Hb F interference.
- Enzymatic creatinine assays are recommended for reliable kidney function evaluation in pediatric cases due to superior specificity.
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