Dear all,

 

I have serious concerns about the spread of creatinine/eGFRr results on the NEQAS scheme.

 

I know this is nothing new and am aware of NEQAS past efforts to try and resolve this using slope adjustments – but has that been effective in any way?

 

At present our method group is running with a positive bias of around 15-20% against the ALTM – which clearly is unsatisfactory. However, is the ALTM the “true” creatinine?

 

I am not particularly in favour of “adjusting calibration” but something needs to be done.

Is there a WHO material available that could be used to “anchor” our method/s against? Or even better, is there a WHO standard available which the manufacturer’s could calibrated all their assays with? (perhaps they are already doing this?).

I am aware that this is a complex issue as many of the picrate methods are non-linear in any case. However until we can all afford to run enzymatic assays we have a problem to deal with as many of our patients are currently getting classified as CKD erroneously.

 

I am sure NEQAS, and others have views on this but I for one would appreciate a rapid solution to this unsatisfactory situation.

 

Regards

 

Ian