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Summary

Serum creatinine levels can fluctuate due to measurement interferences, not just true kidney function changes. Healthcare workers must critically interpret results from renal function estimating equations.

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Area of Science:

  • Clinical Chemistry
  • Nephrology
  • Biomedical Measurement

Background:

  • Serum creatinine is a key biomarker for estimating kidney function.
  • Variations in reported serum creatinine concentrations can occur independently of actual changes in renal function.
  • Accurate creatinine measurements are crucial for diagnosing and staging chronic kidney disease (CKD).

Purpose of the Study:

  • To highlight the factors contributing to variability in serum creatinine measurements.
  • To emphasize the importance of critical interpretation of estimated glomerular filtration rate (eGFR) values.
  • To inform healthcare professionals about potential interferences affecting creatinine assays.

Main Methods:

  • Review of factors influencing serum creatinine levels, including endogenous production, dietary intake, and assay interferences.
  • Discussion of Jaffe and enzymatic methods and their susceptibility to interference.
  • Analysis of the impact of these variations on the reliability of renal function estimating equations.

Main Results:

  • Serum creatinine variability stems from true physiological changes and measurement interferences.
  • Interferences include chromogenic browning in Jaffe methods and reaction modifiers in enzymatic assays.
  • Dietary creatine and endogenous production also impact serum creatinine levels.
  • These factors can lead to inaccurate estimations of glomerular filtration rate (eGFR).

Conclusions:

  • Reported serum creatinine values may not always accurately reflect true renal function due to various interferences.
  • Healthcare professionals should exercise critical judgment when interpreting eGFR results derived from serum creatinine.
  • Over-reliance on eGFR without considering potential measurement issues can lead to misdiagnosis or inappropriate patient management.