Document Detail


Modeling the variability of creatinine measurements improves estimates of the glomerular filtration rate.
MedLine Citation:
PMID:  18076358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The precision of the formulae used to estimate glomerular filtration rate (GFR) decreases when the serum creatinine (SCr) assay is biased compared with the assay used during the development of the formulae. METHODS: For 100 children referred for 51Cr-EDTA clearance (CLEDTA), SCr was measured with a JAFFE (classic Jaffe colorimetric creatinine assay), a compensated Jaffe (COMP), an enzymatic (ENZ) and an HPLC assay. A population pharmacokinetics approach based on a non-linear mixed effects model (NONMEM) was used to model the relationships between the CLEDTA and physiopathological/analytical variables. RESULTS: Unlike JAFFE values, COMP and ENZ SCr gave a high bias using the Schwartz formula for the GFR calculation (median +27.0% and +39.1%, respectively). The best equation obtained from the analysis of the curves of [51Cr-EDTA]plasma vs. time was (n=67): CLEDTA (mL/min)=61.9 x [SCr (microM)/Theta]Psi x [age (years)/13.4]0.522 x (weight (kg)/44.2)0.233. The SCr assay-related coefficients and exponents were Theta=97.4, Psi=-0.757 (-0.922; -0.592) for JAFFE; Theta=85.3, Psi=-0.579 (-0.681; -0.477) for COMP; and Theta=82.6, Psi=-0.560 (-0.659; -0.460) for ENZ. When applied to 33 children, this equation estimated CL(EDTA) without any significant bias: +3.1% (-11.8; +11.4) for COMP and +5.3% (-7.2; +16.4) for ENZ. CONCLUSIONS: As long as there is no standardization of SCr measurements, population pharmacokinetics may be a powerful tool to model inter-assay variability.
Authors:
Sophie Séronie-Vivien; François Bouissou; Sophie Dattez; Yvon Coulais; Anne-Marie Hanser; Bernadette Hym; Etienne Chatelut
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical chemistry and laboratory medicine : CCLM / FESCC     Volume:  46     ISSN:  1434-6621     ISO Abbreviation:  Clin. Chem. Lab. Med.     Publication Date:  2008  
Date Detail:
Created Date:  2008-03-07     Completed Date:  2008-05-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9806306     Medline TA:  Clin Chem Lab Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  215-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Biology, Institut Claudius Regaud, Université Paul Sabatier, Toulouse, France. seronie-vivien.sophie@claudiusregaud.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Chromatography, High Pressure Liquid
Creatinine / blood*
Female
Glomerular Filtration Rate*
Humans
Infant
Male
Chemical
Reg. No./Substance:
60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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