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Clinically important intermethod differences for physiologically abnormal ionized magnesium results

S A Cecco1, E N Hristova, N N Rehak

  • 1Clinical Pathology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892-1508, USA.

American Journal of Clinical Pathology
|November 14, 1997
PubMed
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Ionized magnesium (iMg) measurements differ significantly between AVL and Nova ISE analyzers, impacting clinical interpretation. These discrepancies require resolution for reliable patient care using iMg testing.

Area of Science:

  • Clinical Chemistry
  • Biomedical Engineering
  • Medical Diagnostics

Background:

  • Ionized magnesium (iMg) is a critical electrolyte influencing numerous physiological processes.
  • Accurate iMg measurement is essential for diagnosing and managing various medical conditions.
  • Ion-selective electrodes (ISEs) are commonly used for iMg determination in clinical settings.

Purpose of the Study:

  • To compare ionized magnesium (iMg) results from two different ISE analyzers: AVL 988-4 and Nova CRT.
  • To assess the agreement and identify discrepancies in iMg measurements, particularly for abnormal low and high values.
  • To evaluate the clinical interpretation agreement between the two methods.

Main Methods:

  • Serum samples from randomly selected patients were analyzed for iMg using AVL 988-4 and Nova CRT ISEs.

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  • Samples were categorized into low (< 0.39 mmol/L) and high (> or = 0.65 mmol/L) iMg groups.
  • Intermethod differences were analyzed, focusing on samples with normal total magnesium concentrations.

    • Main Results:

    • Significant differences in iMg results were observed between the AVL and Nova ISEs within both low and high iMg groups.
    • For samples with normal total magnesium, 83% of low iMg results were flagged as abnormal by the Nova ISE, while AVL showed normal results.
    • For high iMg groups, AVL ISE results were consistently high, whereas Nova ISE yielded normal results in 67% of cases.
    • Clinical interpretation agreement based on method-specific reference intervals was only 32%.

    Conclusions:

    • Substantial intermethod differences exist between AVL and Nova ISE analyzers for ionized magnesium (iMg) measurements.
    • These discrepancies significantly affect the clinical interpretation of iMg test results.
    • Resolution of these analytical differences is crucial before widespread clinical adoption of ISE-based iMg testing for patient care.