Hi Rick/Michael,
Enzymatic Creatinine has never been popularized by the IVD industry.
Vitros platform has only Enzymatic Cr and their price is comparitively less than other Enz Cr assays on 'wet' chemistry analysers.
Lab Medicine Specialists should be more demanding for Enz assay and its high time to move over from Jaffe.
In my lab I had struggled to meet precision on Jaffe assay. Roche Rate blanked assay assumes a constant protein level. This assay is grossly inaccurate for pediatric, critically ill and elderly patients.
CKD and AKI guidelines focus on early detection and clinically significant changes. Unless the MoU is low enough its difficult to do justice from a Lab perspective.
Thus its high time we start pushing the IVD industry on Enz Cr.
Best Regards,
Sutirtha
Regards,
Dr Sutirtha Chakraborty
MBBS, MD, FACB
Consultant & Head,
Dept of Biochemistry,
Peerless Hospital ,
Kolkata, India
Mobile: +91 9874787638
Sent on my BlackBerry® from Vodafone
-----Original Message-----
From: "COLLINS MICHAEL (RM1) Norfolk and Norwich University Hospital"
<[log in to unmask]>
Sender: Clinical biochemistry discussion list <[log in to unmask]>
Date: Mon, 17 Feb 2014 17:00:58
To: <[log in to unmask]>
Reply-To: "COLLINS MICHAEL (RM1) Norfolk and Norwich University Hospital"
<[log in to unmask]>
Subject: Re: I'm confused......
From Sigma the enzymes for creatinine cost about 2.3x as much as those for hexokinase glucose.
Our enzymatic creatinine costs 2.17x as much as glucose per test
Mike Collins
BMS3
Biochemistry Automation
Norfolk & Norwich University Hospital
England
[log in to unmask]
http://www.nnuh.nhs.uk/
-----Original Message-----
From: Richard Jones [Pathology] [mailto:[log in to unmask]]
Sent: 17 February 2014 12:35
To: COLLINS MICHAEL (RM1) Norfolk and Norwich University Hospital
Subject: RE: I'm confused......
Hi good to hear from you.
Yes I know chemicals will have different prices but for similar stuff in volume they tend to be the same. Is the enzyme in this assay so special?
Rick
-----Original Message-----
From: COLLINS MICHAEL (RM1) Norfolk and Norwich University Hospital [mailto:[log in to unmask]]
Sent: 17 February 2014 12:08
To: Richard Jones [Pathology]
Subject: RE: I'm confused......
We moved to enzymatic creatinine some years ago and the results are excellent. We paid for this by removing the even more expensive bicarbonate from U&E except as a reflex test. Note that the even more expensive bicarbonate is also an enzymatic test.
I'm sure the manufacturers are charging what the market will bear but I don't think your question is fair.
Why is sodium chloride so cheap when uranium hexafluoride is so expensive. After all they are both chemicals.
Mike Collins
BMS3
Biochemistry Automation
Norfolk & Norwich University Hospital
England
[log in to unmask]
http://www.nnuh.nhs.uk/
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Richard Jones [Pathology]
Sent: 17 February 2014 11:15
To: [log in to unmask]
Subject: I'm confused......
I've been involved in a lot of discussion recently on AKI and CKD and we keep coming round to agreeing that creatinine's are terrible and all would be well (or at least better ) if we used enzymic tests. The eGFR fiasco taught is that if nothing else and we have good evidence of poor dosing in chemotherapy etc, etc.
I'm also told we can't do this because enzymic test are expensive.
But hold on, we do glucose by enzymic methods and that's cheap as chips so why is creatinine more expensive.
Surely at the volumes we do in the UK the prices should be similar so where is the extra cost incurred.
Anyone have a view or an explanation?
Rick
Dr Rick Jones
Sen Lect, Yorkshire Centre Health Informatics, Univ of Leeds Consultant Chemical Pathologist, Leeds Teaching Hospitals NHS Trust NHS England, National Pathology Programme, Pathology IT Advisor [log in to unmask]
W: www.ychi.leeds.ac.uk/rgjones
T: 0113 343 4961
M: 07976 743 549
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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.
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