Laboratoire de Biochimie, CHRU Montpellier, France.
Clin Biochem. 2012 Mar;45(4-5):320-5. doi: 10.1016/j.clinbiochem.2011.11.008. Epub 2011 Dec 2.
This study aimed to evaluate the impact of two creatinine measurement methods on the Model for End Stage Liver Disease (MELD) score and glomerular filtration rate estimation (eGFR) in cirrhotic patients. We focused on ID-MS traceable method such as compensated Jaffe (cJafCreat) and enzymatic (EnzCreat) methods.
Potential protein-related interferences in creatinine determination were evaluated using dialysates spiked with albumin. MELD score, CKD-EPI formula creatinine-based eGFR and cystatin C-based eGFR were evaluated in 100 cirrhotic patients.
In vitro model demonstrated that low protein levels result in an underestimation of creatinine levels using cJafCreat. In patients, cJafCreat created a negative bias of -6.1 μmol/L that led to higher eGFR and lower MELD scores.
cJafCreat contributes to an overestimation of renal function in cirrhotic patients and may alter cirrhosis-severity assessment. Compensated Jaffe assays should therefore be replaced by enzymatic methods.
本研究旨在评估两种肌酐检测方法对肝硬化患者终末期肝病模型（MELD）评分和肾小球滤过率估计（eGFR）的影响。我们重点关注 ID-MS 可溯源方法，如补偿 Jaffe（cJafCreat）和酶法（EnzCreat）。
使用含有白蛋白的透析液评估肌酐测定中潜在的蛋白相关干扰。在 100 例肝硬化患者中评估 MELD 评分、CKD-EPI 公式基于肌酐的 eGFR 和基于胱抑素 C 的 eGFR。
体外模型表明，低蛋白水平会导致使用 cJafCreat 低估肌酐水平。在患者中，cJafCreat 导致负偏倚 -6.1 μmol/L，导致更高的 eGFR 和更低的 MELD 评分。
cJafCreat 导致肝硬化患者肾功能高估，并可能改变肝硬化严重程度评估。因此，应将补偿 Jaffe 测定法替换为酶法。
