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Dear Jonathan,

 

One answer to the question that you’re asking; the clinical significance of the effect with modern non-enzymatic methods is dependent on the creatinine concentration.

(creatinine measured using cobas Gen.2 Jaffe assay (CREJ2), patient pools spiked with a bilirubin solution prepared from solid bilirubin dissolved in DMSO/NaOH).

 

What is the collective opinion on diluting samples prior to analysis?

 

Regards

Jinny

 

 

Dr Jinny Jeffery (D.Phil, DipRCPATH), Clinical Scientist, Derriford Combined Laboratory, Derriford Hospital, Plymouth, PL6 8DH.

Biochemistry advice is now available at: [log in to unmask]

cid:533264109@05022014-32E5

 

 

 

 

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Kay
Sent: 18 December 2015 09:54
To: [log in to unmask]
Subject: Re: Providing creatinine results in the presence of icterus

 

What’s the size of the effect with modern non-enzymatic methods?

 

Thanks

 

Jonathan

 

On 18 Dec 2015, at 09:25, McKeeman, Gareth <[log in to unmask]> wrote:

 

 

I am interested to know how other labs deal with requests for creatinine results in icteric samples, or indeed if they get such requests. We are running the Roche C8000 enzymatic assay and the manufacturer states that when the icteric level is >257, then the creatinine result should not be reported, due to negative interference. We get a number of requests from our liver teams (and some others) asking for the ‘invalidated’ creatinine result. This is often needed for patients who are on a liver transplant list, as an assessment of kidney function is necessary for their work up. Some requests also relate to monitoring of kidney function in these patients. At present senior staff discuss the clinical need with the requesting clinician and will give the result, with the warning that the result is falsely low.

Some have (wrongly) assumed that the creatinine result released has been ‘corrected’ for the presence of icterus in the sample. This is not the case. Though we have been discussing the possibility of developing such an approach. I would also be interested to know if any labs use any sort of correction algorithm to provide more meaningful data in these circumstances.

 

 

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 ------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/