I am not a great fan of adjusted or estimated values and I have no experience with any of these equations below and how useful or not they might be, but I am asking, in principle, which albumin method was used to derive the below equation? BCP or BCG albumin and would the difference in albumin methodology in itself invalidate the use of this equation in certain settings???
Rita Horvath
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From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of Lynch Mark - Consultant [[log in to unmask]]
Sent: Wednesday, 5 November 2014 9:00 PM
To: [log in to unmask]
Subject: Albumin correction for phenytoin
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I know there has been some discussion about this in the past but was hoping to get the latest opinion on the usefulness of albumin correction for phenytoin measurement – one of our neurologists was looking for some info via our pharmacy department.
Another Trust in our region uses the following equation: Ccorr = Cobs/((0.9 x alb/39) +0.1) [use 0.48 rather than 0.9 in renal failure) but I am not too sure where this comes from.
My very partial understanding is that it is of limited usefulness as there appears to be relatively poor correlation between the calculated and the measured free values especially if the patient has renal/liver disease and is on other drugs such as valproate.
Is this in widespread use in the UK?
Would anybody have a reference for the above or similar equations?
Regards and Thank you
Mark Lynch
Clinical Biochemist
Altnagelvin Hospital
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