Abstract
Abstract Objectives Our aim was to validate a mass spectrometric creatinine method and compare this method with Jaffe and enzymatic serum creatinine methods. Methods 90 samples were included. The levels were classified into three groups according to serum creatinine results as Group 1: Lower (n=30) (0.16–0.59 mg/dL), Group 2: Normal (n=30) (0.62–1.18 mg/dL) and Group 3: Higher (n=30) (1.33–3.88 mg/dL). Jaffe and enzymatic creatinine measurements were performed on the Beckman Coulter AU5800 autoanalyzer. Results Serum creatinine was linear from 0.039 up to 10 mg/dL, CV and bias values were ranged between 1.9–3.8% and 2–15%. Correlation coefficients were 0.990 (95% confidence interval 0.984–0.993), 0.992 (95% confidence interval 0.988–0.995) and 0.994 (95% confidence interval 0.991–0.996) for LC-MS/MS-Enzymatic, LC-MS/MS-Jaffe and Enzymatic-Jaffe, respectively. Conclusions Although, Jaffe method for serum creatinine measurement is still much more practical and cheap, so in use for routine practice, tandem mass spectrometric detection of serum creatinine can be used as an accurate and specific method for verification of discordant clinical results, existence of possible interferences and serum levels under 0.5 mg/dL creatinine results such as pediatric or pregnant populations.
Highlights
Glomerular filtration rate has been defined as the best indicator of renal function in disease and health for many years
Method validation for serum creatinine in LC-MS/MS was completed according to CLSI rules, and a comparison of the results obtained by measuring 130 samples, 20 pre- and 20 post-dialysis, 30 in the reference range, 30 with serum creatinine values below the reference range and 30 above the reference range was conducted with the enzymatic, mass spectrometric and Jaffe creatinine methods
It has been reported that enzymatic creatinine measurement is much more expensive and less prone to interferences compared to Jaffe
Summary
Glomerular filtration rate has been defined as the best indicator of renal function in disease and health for many years. Serum creatinine is measured by a colorimetric method called Jaffe. This reaction based on the yellow– orange color formation of picric acid is vulnerable to interference with some chromogens, including bilirubin, proteins, acetoacetate, drugs (cefazolin), glucose and ascorbic acid [2]. Isotope dilution-mass spectrometry (IDMS) traceable methods such as compensated Jaffe or enzymatic creatinine measurement have been developed to address these interferences and improve precision and reduce the bias [3]. Despite these technical improvements, the pitfalls in creatinine measurement could not be overwhelmed. Methods of creatinine analysis in urine [6], dried blood spot [7] and serum samples [8] have been reported in the literature
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