Elimination of Bilirubin Interference in Creatinine Assays by Routine Techniques: Comparisons with a High Performance Liquid Chromatography Method

Abstract

SUMMARY. The aim of this study was to find a method for creatinine analysis unaffected by jaundice by comparing four different methods with high performance liquid chromatography (HPLC) as a reference method. The methods investigated were Kodak DTSC single slide, Boehringer alkaline picrate with and without blank correction and a Boehringer enzymatic method, the last three using the Hitachi 737 analyser.HPLC results were compared with the results of the methods studied. In addition, graphs plotting the difference from the HPLC result against the bilirubin concentration were made; the ideal method would yield a slope and intercept of zero.While all methods showed a positive bias compared with HPLC, the Kodak slide and the Boehringer alkaline picrate with blank correction methods eliminated bilirubin interference and we have changed to the latter method as a consequence of this work.

Sieving coefficient inaccuracies during hemodiafiltration in patients with hyperbilirubinemia

“…Our observation suggests that in hyperbilirubinemic patients the sieving coefficient should preferentially be based upon the urea nitrogen value. If creatinine is used, then its plasma value should be estimated by the enzymatic method, which is unaffected by the presence of hyperbilirubinemia [13].…”

The evaluation of renal function and disease in patients with cirrhosis

“…For example, when four different methods of creatinine dosage are applied in patients with serum bilirubin between 200 and 400 lmol/L, a difference in MELD score P2 points may be observed in about 60% [18]. Several techniques such as deproteinization, the use of bilirubin oxidase or kinetic alkaline picrate methods may help overcome this interference [19,20]. However, the dosage of serum creatinine has not been standardized.…”

Exogenous interferences with Jaffe creatinine assays: addition of sodium dodecyl sulfate to reagent eliminates bilirubin and total protein interference with Jaffe methods

“…Several approaches have been used to minimize nonspecific interferences, such as deproteinization for eliminating the pseudo-chromogen effect of protein (16), early read reaction times (17), addition of some chemicals in reagent systems (18,19), rate-blanking measurement (20), higher temperatures (21), or use of single value compensation for noncreatinine Jaffe reacting chromogens (22). Using the enzymatic creatinine assays, although often recommended as the method of choice, they can have their own interference problems (23).…”