Enzymatic creatinine assays allowestimation of glomerular filtration rate in stages 1 and 2 chronic kidney disease using CKD-EPI equation

The National Kidney Disease Education Program group demonstrated that MDRD equation is sensitive to creatinine measurement error, particularly at higher glomerular filtration rates. Thus, MDRD-based eGFR above 60 mL/min/1.73 m2 should not be reported numerically. However, little is known about the impact of analytical error on CKD-EPI-based estimates. This study aimed at assessing the impact of analytical characteristics (bias and imprecision) of 12 enzymatic and 4 compensated Jaffe previously characterized creatinine assays on MDRD and CKD-EPI eGFR. In a simulation study, the impact of analytical error was assessed on a hospital population of 24 084 patients. Ability using each assay to correctly classify patients according to chronic kidney disease (CKD) stages was evaluated. For eGFR between 60 and 90 mL/min/1.73 m2, both equations were sensitive to analytical error. Compensated Jaffe assays displayed high bias in this range and led to poorer sensitivity/specificity for classification according to CKD stages than enzymatic assays. As compared to MDRD equation, CKD-EPI equation decreases impact of analytical error in creatinine measurement above 90 mL/min/1.73 m2. Compensated Jaffe creatinine assays lead to important errors in eGFR and should be avoided. Accurate enzymatic assays allow estimation of eGFR until 90 mL/min/1.73 m2 with MDRD and 120 mL/min/1.73 m2 with CKD-EPI equation.Peer reviewe

[Urinary biomarkers of kidney dysfunction].

International audienceThe early diagnosis of chronic kidney disease (CKD) is based on the detection of markers of renal damage in urine collection. These urinary bio-markers are measurable before the appearance of functional defect, which is diagnosed with a decrease of glomerular filtration rate. Albuminuria, preferentially expressed as urinary albumin/creatinin ratio, is one of the marker of CKD. But today, other urinary biomarkers, monitoring tubulointersticial damage, are of interest in early diagnosis of CKD. In acute kidney injury, these markers could improve diagnostic tests, since they increase faster than serum creatinin. We propose a review of the urinary biomarkers of renal dysfunction used in routine clinical practice in 2015

[Vascular calcifications: can the biologist be of some help?].

International audienc

Did Creatinine Standardization Give Benefits to the Evaluation of Glomerular Filtration Rate?

International audienc

Impact de la stabilité de la cystatine C sur la validité des mesures dans les études rétrospectives

peer reviewe

A Pathway to National Guidelines for Laboratory Diagnostics of Chronic Kidney Disease - Examples from Diverse European Countries.

International audienceThe principal benefit of guidelines is to improve the quality of care received by patients. In the 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (KDIGO) was released and it is designed to provide information and assist decision making. This review gives a brief overview of a various national CKD guidelines that rely on the newly released KDIGO guidelines. All of the included countries (France, Turkey, Norway and Croatia) are non-English speaking countries and they differ in population and socio economic aspects. Examples shown in this review may provide valuable experience for countries that are in process of creating their national CKD guidelines

Multilevel qualification of a large set of blood gas analyzers: Which performance goals?

International audienc

Recommandations pour le choix et l'harmonisation des techniques de dosage de la créatinine

En 2010, un groupe de travail mixte constitué de la Société française de biologie clinique (SFBC) et de la Société de nephrologie (SN) a formulé les propositions suivantes afin de réactualiser les recommanadations pour le dosage de la créatinine plasmatique

Serum creatinine: advantages and pitfalls

Serum creatinine (sCr) is today the most commonly used marker to estimate glomerular filtration rate (GFR). However, measuring and interpreting creatinine is not so simple. Some physiological reasons, particularly its dependence on muscle mass makes sCr an imperfect biomarker of GFR. However, there are also analytical reasons that could be further improved. The implementation of ID-MS traceable creatinine assays (enzymatic and compensated Jaffe) improved estimation of GFR by reducing bias. Enzymatic methods which are more precise and less susceptible to interfere with non-creatinine chromogens than compensated Jaffe methods, provide more reliable estimations of GFR