Compensating for the influence of total serum protein in the Schwartz formula.

Abstract:

BACKGROUND:The Schwartz 2009 creatinine-based revised formula is the only pediatric GFR estimating formula, which is compatible with the recent global creatinine standardization. This formula is only applicable if enzymatic creatinine methods are used. We propose an equation, taking into account the relative bias caused by serum proteins to use Jaffe based creatinine data for GFR estimation. METHODS:In a cohort study of 100 pediatric patients, serum creatinine was measured using a kinetic rate-blanked Jaffe assay (modified kinetic alkaline picrate method), a kinetic rate-blanked Jaffe compensated assay for reactive proteins and an enzymatic assay (creatinine plus method). Serum total protein, albumin, urea, uric acid and total bilirubin were measured with the use of commercial agents. RESULTS:The difference in serum creatinine between the enzymatic method and the compensated Jaffe method was mainly dependent on the total protein concentration in serum (r(2)=0.61, p<0.001). After applying the proposed protein correction, corrected compensated Jaffe results and creatinine clearance values became interchangeable with enzymatic serum creatinine results (r(2)=0.99, p<0.001; Deming regression: slope: 0.9787, intercept: -0.351) and with the newly proposed Schwartz formula, respectively (r(2)=0.99, p<0.001; Deming regression: slope 1.004, intercept: 2.16). CONCLUSIONS:In this study, we demonstrated the usability of the alkaline picrate method in the Schwartz formula, taking into account the relative bias caused by serum proteins.

journal_name

Clin Chem Lab Med

authors

Speeckaert MM,Wuyts B,Stove V,Walle JV,Delanghe JR

doi

10.1515/cclm-2012-0033

subject

Has Abstract

pub_date

2012-03-09 00:00:00

pages

1597-600

issue

9

eissn

1434-6621

issn

1437-4331

pii

/j/cclm.2012.50.issue-9/cclm-2012-0033/cclm-2012-0

journal_volume

50

pub_type

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