Study of appropriate methods for plasma creatinine screening for renal function assessment according to the international standard
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Abstract
Background: Kidney disease is a major public health problem in Thailand. Kidney Association of Thailand and the International Commission recommended estimated glomerular filtration rate (eGFR) obtained from enzymatic measurement of plasma creatinine level to assess the kidney function. However, the strategy cannot be applied to all patients due to budget limitation.
Objectives: This study was aimed to compare enzymatic and modified Jaffe’s methods in measuring plasma creatinine level. Relationship of the two techniques of evaluating the kidney function, eGFR and CKD staging based on creatinine reference levels obtained from modified Jaffe’s method and enzymatic method was also determined.
Materials and methods: Plasma creatinine levels were measured in 433 routine blood samples as grouped by gender at the clinical laboratory of Payao Hospital. Enzymatic method was compared to modified Jaffe’s methods. Eight groups of these blood samples were subsequently obtained based on plasma creatinine levels. Thereafter, creatinine levels from both methods were used to calculate eGFR following the CKD-EPI formula as well as to assess the severity of kidney disease according to CKD staging criteria.
Results: In group of plasma creatinine less than 2.00 mg/dL, creatinine levels obtained from modified Jaffe’s method were higher than those of enzymatic method. In contrast, the opposite results were found in blood samples having plasma creatinine of more than 2.00 mg/dL. Values of eGFR was not different in blood samples having plasma creatinine less than 2.00 mg/dL and more than 5.00 mg/dL. However, eGFR values were significantly different in blood samples of both genders having plasma creatinine levels between 2.00-5.00 mg/dL. The relationships of eGFR from both methods in all ranges of plasma creatinine levels were good (Pearson r-value =0.972 and 0.993). Finally, CKD staging of kidney disease based on plasma creatinine levels as obtained by thesetwo methods was correlated extremely well (Pearson r-value =0.992 and 0.987).
Conclusion: Both modified Jaffe’s and enzymatic method can be used in blood samples having plasma creatinine levels of less than 2.00 mg/dL and more than 5.00 mg/dL. However, only enzymatic method can be used in blood samples having plasma creatinine levels between 2.00-5.00 mg/dL. This finding can be applied in the routine clinical laboratories.
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
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