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I do not think that the eGFR and the AKI initiative can be supported by the Jaffe method. The NHS should have been advised before the eGFR and the AKI initiatives were introduced, that the whole foundation of the initiatives (i.e. the creatinine result) should have been made fit for purpose. The amount of money invested into the initiatives (such as increase workload, increased nurse and consultant staff etc) far outweigh the amount of money required to introduce a decent creatinine method into the UK. Once again, silo budgeting for pathology, ignoring the cost and effect on the patient pathway has led to the AKI and eGFR "house" being built on dodgy foundations in some parts of the country. Martin Ps I introduced a traceable enzymatic creatinine method many years ago. -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST) Sent: 13 April 2015 10:53 To: [log in to unmask] Subject: Re: AKI alert (Wales) --- This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within. The identified sender is [log in to unmask] --- Out of interest, do all labs in Wales run enzymatic Creatinine's? And following on with that, do other labs currently running Jaffe, plan to move to enzymatic?. We are currently Jaffe in Exeter, our running CV (all analysers, all controls, all levels) = 5.43% If you figure in the biological variation and use the Westgard formula to calculate what a significant rise would be between two sequential results that gives you around 14% difference. That’s not great when your applying the >26 umol/L part of the algorithm. Is there any national cash available to change to enzymatic, which I would love to do?. BW John -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Gethin Roberts Sent: 13 April 2015 10:20 To: [log in to unmask] Subject: AKI alert (Wales) All labs in Wales are now live on the Intersystems TCL LIMS with the recommended UK algorithm. This is running for both primary and secondary care. We are currently investigating various ways of proactively communicating stage 2 and 3 alerts and providing a link from the alert in the Welsh Clinical Portal to agreed all Wales Management Guidelines. Gethin Roberts Wales AKI Steering Group ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ******************************************************************************************************************** This message may contain confidential information. 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