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A Convenient Method for Extraction and Analysis with High-Pressure Liquid Chromatography of Catecholamine Neurotransmitters and Their Metabolites
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Catecholamine interference in enzymatic creatinine assays.

Amy K Saenger1, Christina Lockwood, Christine L Snozek

  • 1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.

Clinical Chemistry
|July 11, 2009
PubMed
Summary
This summary is machine-generated.

Catecholamines like dopamine can interfere with enzymatic creatinine tests, causing falsely low results, especially when using indwelling catheters. Alternative testing methods are recommended for accuracy.

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Area of Science:

  • Clinical Chemistry
  • Analytical Toxicology

Background:

  • Enzymatic creatinine assays offer improved specificity over Jaffe methods for estimating glomerular filtration rate.
  • Observed negative interferences in patients receiving dopamine or dobutamine prompted investigation into catecholamine effects on enzymatic creatinine assays.

Purpose of the Study:

  • To investigate the interference of catecholamines (dopamine, dobutamine, epinephrine, norepinephrine) with enzymatic creatinine assays.
  • To compare interference levels across different enzymatic and Jaffe creatinine assay platforms.
  • To evaluate in vivo creatinine interference in samples from patients receiving catecholamines via indwelling catheters versus venipuncture.

Main Methods:

  • Catecholamines were spiked into pooled sera at clinically relevant concentrations.
  • Creatinine was measured using enzymatic assays (Roche P-Modular, Ortho Vitros, Abbott i-STAT) and Jaffe methods (Roche P-Modular, Siemens Dimension).
  • Paired serum samples from 10 patients on dopamine/dobutamine were analyzed from indwelling catheters and venipuncture.

Main Results:

  • All tested catecholamines caused significant negative interference with the Roche enzymatic assay, particularly dopamine and dobutamine.
  • The Ortho Vitros enzymatic assay showed slight negative interference; Abbott i-STAT enzymatic and Jaffe methods were unaffected.
  • Significant differences in creatinine levels were found between catheter and venipuncture samples, suggesting reversible adherence of catecholamines to catheters.

Conclusions:

  • Enzymatic creatinine assays, especially the Roche platform, are susceptible to significant negative interference from catecholamines in samples from indwelling catheters.
  • This interference can lead to falsely low creatinine results.
  • Physicians and laboratorians should consider alternative methods for patients on catecholamines, particularly when using indwelling catheters.