Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice
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 ev...
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1236948/full |
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| author | Regina Demlova Sarka Kozakova Sarka Kozakova Michal Rihacek Michal Rihacek Michal Rihacek Dana Buckova Dana Buckova Katerina Horska Katerina Horska Ondrej Wiewiorka Ondrej Wiewiorka Lubos Boucek Iveta Selingerova Iveta Selingerova Martina Podborska Martina Podborska Alena Korberova Alena Korberova Alena Mikuskova Alena Mikuskova Jiri Starha Jiri Starha Miroslava Benovska Miroslava Benovska Martin Radina Martin Radina Martin Radina Michal Richter Lenka Zdrazilova Dubska Lenka Zdrazilova Dubska Lenka Zdrazilova Dubska Dalibor Valik Dalibor Valik Dalibor Valik Dalibor Valik |
| author_facet | Regina Demlova Sarka Kozakova Sarka Kozakova Michal Rihacek Michal Rihacek Michal Rihacek Dana Buckova Dana Buckova Katerina Horska Katerina Horska Ondrej Wiewiorka Ondrej Wiewiorka Lubos Boucek Iveta Selingerova Iveta Selingerova Martina Podborska Martina Podborska Alena Korberova Alena Korberova Alena Mikuskova Alena Mikuskova Jiri Starha Jiri Starha Miroslava Benovska Miroslava Benovska Martin Radina Martin Radina Martin Radina Michal Richter Lenka Zdrazilova Dubska Lenka Zdrazilova Dubska Lenka Zdrazilova Dubska Dalibor Valik Dalibor Valik Dalibor Valik Dalibor Valik |
| author_sort | Regina Demlova |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T16:05:27Z |
| format | Article |
| id | doaj.art-5ec3912abd9648dc96a95cf8f904ac79 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-08T16:05:27Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-5ec3912abd9648dc96a95cf8f904ac792024-01-08T06:32:01ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-01-011010.3389/fmed.2023.12369481236948Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practiceRegina Demlova0Sarka Kozakova1Sarka Kozakova2Michal Rihacek3Michal Rihacek4Michal Rihacek5Dana Buckova6Dana Buckova7Katerina Horska8Katerina Horska9Ondrej Wiewiorka10Ondrej Wiewiorka11Lubos Boucek12Iveta Selingerova13Iveta Selingerova14Martina Podborska15Martina Podborska16Alena Korberova17Alena Korberova18Alena Mikuskova19Alena Mikuskova20Jiri Starha21Jiri Starha22Miroslava Benovska23Miroslava Benovska24Martin Radina25Martin Radina26Martin Radina27Michal Richter28Lenka Zdrazilova Dubska29Lenka Zdrazilova Dubska30Lenka Zdrazilova Dubska31Dalibor Valik32Dalibor Valik33Dalibor Valik34Dalibor Valik35Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Pharmacology, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Pharmacy, University Hospital Brno, Brno, CzechiaDiagnostic and Therapeutic Centre, Emergency Services Department, University Hospital Brno, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Masaryk University, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Masaryk University, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Pharmacy, Clinical Pharmacy Services Unit, University Hospital Brno, Brno, CzechiaDepartment of Pharmacology and Toxicology, Faculty of Pharmacy, Masaryk University, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Brno, CzechiaDepartment of Pharmacology, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Mathematics and Statistics, Faculty of Science, Masaryk University, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia0Department of Pediatric Hematology and Biochemistry, University Hospital Brno, Brno, Czechia1Department of Pediatrics, Pediatric Nephrology Unit, University Hospital Brno, Brno, Czechia2Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Brno, Czechia3Research Unit for Rare Diseases, Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czechia4General Teaching Hospital, Prague, Czechia5Spadia Laboratories, Central Reference Lab, Division of Clinical Biochemistry, Ostrava, Czechia5Spadia Laboratories, Central Reference Lab, Division of Clinical Biochemistry, Ostrava, CzechiaDepartment of Pharmacology, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Brno, CzechiaDepartment of Pharmacology, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, CzechiaDepartment of Laboratory Medicine, University Hospital Brno, Brno, Czechia6Department of Pediatric Oncology, University Hospital Brno, Brno, CzechiaBackgroundAssessment 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.https://www.frontiersin.org/articles/10.3389/fmed.2023.1236948/fullcreatininerenal functionseGFRurgent care medicationcystatin C |
| spellingShingle | Regina Demlova Sarka Kozakova Sarka Kozakova Michal Rihacek Michal Rihacek Michal Rihacek Dana Buckova Dana Buckova Katerina Horska Katerina Horska Ondrej Wiewiorka Ondrej Wiewiorka Lubos Boucek Iveta Selingerova Iveta Selingerova Martina Podborska Martina Podborska Alena Korberova Alena Korberova Alena Mikuskova Alena Mikuskova Jiri Starha Jiri Starha Miroslava Benovska Miroslava Benovska Martin Radina Martin Radina Martin Radina Michal Richter Lenka Zdrazilova Dubska Lenka Zdrazilova Dubska Lenka Zdrazilova Dubska Dalibor Valik Dalibor Valik Dalibor Valik Dalibor Valik Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice Frontiers in Medicine creatinine renal functions eGFR urgent care medication cystatin C |
| title | Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice |
| title_full | Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice |
| title_fullStr | Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice |
| title_full_unstemmed | Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice |
| title_short | Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice |
| title_sort | emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme based methods real world clinical evidence and implications for clinical practice |
| topic | creatinine renal functions eGFR urgent care medication cystatin C |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1236948/full |
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