From:
Sent: 04 May 2007 10:42
To:
Subject: Total Bilirubin on the Abbott
Aeroset
Dear List
Members
Many Aeroset users may be aware of
the interference by indoxyl sulphate (found in the serum of patients with severe
renal disease) on the "new" Abbott total bilirubin (diazo) method. (6L45-20 or
6L45-40).
The method was designed to replace
the oxidation method 7D60-02.
Abbott state in the pack insert that
the addition of 0.25 mmol/L indoxyl sulphate to specimens increased the total
bilirubin by a maximum of 1.5 mg/dL. Read casually, this may not seem important
(even if you realize that 1.5 mg/dL is 25.7 mmol/L). We are all used to
adding a few hundred mg of cholesterol to steroid assays and the cross
reactivity making no difference.
However after changing to the diazo
method, our renal physician contacted us almost immediately to ask what had
happened to the bilirubin method?
Patients on haemodialysis monitored
regularly, suddenly showed an increase in
bilirubin.
We have moved back to the oxidation
method, pending a "fix" from Abbott for the diazo method. While we had both
methods on our Aerosets, we did a very brief comparison, shown below (oxidation
method in brackets) in umol/L:
Renal Unit (haemodialysis): 19 (5),
30 (4), 34 (5), 23 (3), 15 (5), 36 (3), 21 (3)
Graham Ellis and Stephen
McCombe
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