loading page

Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence
  • +14
  • Regina Demlova,
  • Sarka Kozakova,
  • Michal Řiháček,
  • Dana Buckova,
  • Katerina Horska,
  • Ondrej Wiewiorka,
  • Lubos Boucek,
  • Iveta Selingerova,
  • Martina Podborska,
  • Alena Korberova,
  • Alena Mikuskova,
  • Jiri Starha,
  • Miroslava Benovska,
  • Martin Radina,
  • Michal Richter,
  • Lenka Zdrazilova Dubska,
  • Dalibor Valik
Regina Demlova
Masaryk University Faculty of Medicine
Author Profile
Sarka Kozakova
Brno University Hospital
Author Profile
Michal Řiháček
Masaryk University Faculty of Medicine
Author Profile
Dana Buckova
Masaryk University Faculty of Medicine
Author Profile
Katerina Horska
Brno University Hospital
Author Profile
Ondrej Wiewiorka
Masaryk University Faculty of Medicine
Author Profile
Lubos Boucek
Masaryk University Faculty of Medicine
Author Profile
Iveta Selingerova
Masaryk University Faculty of Medicine
Author Profile
Martina Podborska
Masaryk University Faculty of Medicine
Author Profile
Alena Korberova
Brno University Hospital
Author Profile
Alena Mikuskova
Masaryk University Faculty of Medicine
Author Profile
Jiri Starha
Brno University Hospital
Author Profile
Miroslava Benovska
Masaryk University Faculty of Medicine
Author Profile
Martin Radina
Spadia Laboratories
Author Profile
Michal Richter
Spadia Laboratories
Author Profile
Lenka Zdrazilova Dubska
Masaryk University Faculty of Medicine
Author Profile
Dalibor Valik
Masaryk University Faculty of Medicine

Corresponding Author:[email protected]

Author Profile

Abstract

Background: Assessment of kidney function in emergency settings is essential across all medical subspecialties. Daily assessment of patient creatinine result from emergency medical services showed that some creatinine results apparently deviated from expected creatinine values implying occurrence of drug-related interferences. Methods: Real-time head-to-head clinical evaluation of an enzyme method (Roche CREP2) in comparison to Jaffé gen. 2 method (Roche CREJ2) was performed. During the period of December 2022 and January 2023 we analyzed 8498 patient specimens where 5524 were heavily medicated STAT patient specimens, 500 were pediatric specimens and 2474 specimens were from a distant general population in a different region using the same methods. Results: About 5 percent of hospital specimens having patient history showed apparent drops of creatinine concentrations by the enzyme method against the compensated Jaffé method. Suspect medication was found in 43 out of 46 reviewed patients where medication data were allowed for review. A general patient cohort showed no drops of concentrations measured by the enzyme method. Pediatric hospital cohort showed 6 drops out of 500 total measurements. Conclusions: Pharmacotherapy-induced inaccuracies with enzyme creatinine methods imply the need for proper method validations in the relevant patient population such as emergency hospital setting and may facilitate introduction of cystatin C to emergency medicine clinical practice as suitable creatinine alternate biomarker.