Plasma creatinine below limit of quantification in a patient with acute kidney injury

Orieux, Arthur; Brunier, Julien; Rigothier, Claire; Pinson, Benoı̂t; Dabernat, Sandrine; Bats, Marie-Lise

doi:10.1016/j.cca.2021.12.001

Cited by 7 publications

(1 citation statement)

References 18 publications

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“…During the past two decades, Jaffé methods have been widely replaced by enzyme-based colorimetric methods employing sarcosine oxidase/peroxidase reaction chemistry ( 2 ). It has been shown repeatedly that enzymatic methods are susceptible to negative interference caused by several drugs, such as etamsylate ( 3 ), metamizole ( 4 , 5 ), paracetamol, N-acetyl-p-benzoquinone imine (NAPQUI) ( 5 ), acetylcysteine ( 6 ), derivatives of salicylic acid ( 5 , 7 ), high-dose acidum ascorbicum ( 8 ), and dobesilate ( 9 ). Negative interference by catecholamines at clinically relevant concentrations was also shown to affect these methods ( 10 ), and recently, monoclonal immunoglobulins have also been reported to interfere ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice

Demlova,

Kozakova,

Rihacek

et al. 2024

Front. Med.

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BackgroundAssessment of kidney function in emergency settings is essential across all medical subspecialties. Daily assessment of patient creatinine results from emergency medical services showed that some deviated from expected values, implying drug-related interference.MethodsReal-time clinical evaluation of an enzyme method (Roche CREP2) in comparison with the Jaffé gen. 2 method (Roche CREJ2) was performed. During the period of December 2022 and January 2023, we analyzed 8,498 patient samples, where 5,524 were heavily medicated STAT patient specimens, 500 were pediatric specimens, and 2,474 were from a distant general population in a different region using the same methods.ResultsIn 109 out of 5,524 hospital specimens (1.97%, p < 0.001), the CREP2 value was apparently (25% or more) lower than CREJ2. Suspect interfering medication was found in a sample of 43 out of 46 reviewed patients where medication data were available. This phenomenon was not observed in the general population.ConclusionIn a polymedicated urgent care hospital population, a creatinine enzyme method produces unreliable results, apparently due to multiple drug-related interferences.

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