Delay in separating blood samples affects creatinine measurement using the Roche kinetic Jaffe method

Ann Clin Biochem 2008;45:83-87
doi:10.1258/acb.2007.007109
© 2008 Association for Clinical Biochemistry

 

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Original Article


Loretta Ford  and
Jonathan Berg


Clinical Biochemistry Department, City Hospital, Dudley Road, Birmingham B18 7QH, UK


Corresponding author: Dr Loretta Ford. Email: Loretta.Ford{at}swbh.nhs.uk


Background: We have examined the effect of delayed sample separation onserum creatinine measurement using the kinetic Jaffe methodand estimated glomerular filtration rate (eGFR), and the impactthis can have on chronic kidney disease (CKD) staging.

Methods: In a preliminary study clotted samples were left at room temperaturefor up to 48 h prior to centrifugation and serum creatininemeasurement on a Roche modular analyser. A larger study thenused paired clotted samples separated at baseline (30 min) andafter 24 h at room temperature. To determine the effect on CKDstaging, eGFR was calculated using the simplified [4-v] Modificationof Diet in Renal Disease formula.

Results: Preliminary study. A significant increase in creatinine concentration (P < 0.001) occurred after a 16 h delay in sample separation.By 48 h the mean increase in creatinine was 29% (range 21–63%).

Twenty-four hour delay study. The mean increase in creatininefor 113 outpatient samples after delaying sample separationby 24 h was 11%, and exhibited considerable individual variation(range 2–87%). CKD staging for 32% of the group changed,26% from stage 1 to 2 and 6% from stage 2 to 3.

Conclusions: Delay in sample separation affects the creatinine measurementusing the Roche kinetic Jaffe reaction, and can result in themisclassification of CKD staging. Laboratories using the kineticJaffe method should not report creatinine results where therehas been a delay in separation. This advice should also be reflectedin practice guidelines.

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