Effects of hemolysis interference on routine biochemistry parameters

Introduction: Hemolysis is still the most common reason for rejecting samples, while reobtaining a new sample is an important problem. The aim of this study was to investigate the effects of hemolysis in different hemolysis levels for mostly used biochemical parameters to prevent unnecessary rejecti-ons. Materials and methods: Sixteen healthy volunteers were enrolled in the study. Four hemolysis levels were constituted according to hemoglobin concentrations and they were divided into five groups: Gro-up I: 0-0.10 g/L, Group II: 0.10-0.50 g/L, Group III: 0.51-1.00 g/L, Group IV: 1.01-2.50 g/L, Group V: 2.51-4.50 g/L. Lysis was achieved by mechanical trauma. Results: Hemolysis interference affected lactate dehydrogenase (LD) and aspartate aminotransfera-se (AST) almost at undetectable hemolysis by visual inspection (plasma hemoglobin 1 g/L). Alanine aminotransferase (ALT), cholesterol, gamma glutamyltransferase (GGT), and inorganic phosphate (P) concentrations were not interfered up to severely hemolyzed levels (hemoglobin: 2.5-4.5 g/L). Albumin, alkaline phosphatase (ALP), amylase, chloride, HDL-cholesterol, creatine kinase (CK), glucose, magnesium, total protein, triglycerides, un-saturated iron binding capacity (UIBC) and uric acid differences were statistically significant, but re-mained within the CLIA limits. Conclusion: To avoid preanalytical visual inspection for hemolysis detection, improper sample rejec-tion, and/or rerun because of hemolysis, it is recommended in this study that, routine determination of plasma or serum free hemoglobin concentrations is important. For the analytes interfered with hemolysis, new samples have to be requested

The effect of storage time and freeze-thaw cycles on the stability of serum samples

Introduction: Optimal storage of serum specimens in central laboratories for a long period for multicenter reference interval studies, or epidemiologic studies remains to be determined. We aimed to examine the analytical stability of chemistry analytes following numerous freeze-thaw and long term storage. Materials and methods: Serum samples were obtained from 15 patients. Following baseline measurement, sera of each subject were aliquoted and stored at -20 ˚C for two experiments. A group of sera were kept frozen for up to 1, 2 and 3 months and then analyzed for stability. The other experiment consisted of one to ten times of freeze and thaw cycles. Total of 17 chemistry analytes were assayed at each time point. The results were compared with those obtained from the initial analysis of fresh samples. Median or mean changes from baseline (T0) concentrations were evaluated both statistically and clinically according to the desirable bias. Results: Of the analytes studied, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), gamma-glutamyl transferase (GGT), direct bilirubin, glucose, creatinine, cholesterol, triglycerides, high density lipoprotein (HDL) were stable in all conditions. Blood urea nitrogen (BUN), uric acid, total protein, albumin, total bilirubin, calcium, lactate dehydrogenase (LD) were changed significantly (P < 0.005). Conclusions: As a result, common clinical chemistry analytes, with considering the variability of unstable analytes, showed adequote stability after 3 months of storage in sera at -20 °C, or up to ten times of freeze-thaw cycle. All the same, such analysis can only be performed for exceptional cases, and this should be taken into account while planning studies

Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors

Introduction: Preanalytical errors, along the process from the beginning of test requests to the admissions of the specimens to the laboratory, cause the rejection of samples. The aim of this study was to better explain the reasons of rejected samples, regarding to their rates in certain test groups in our laboratory. Materials and methods: This preliminary study was designed on the rejected samples in one-year period, based on the rates and types of inappropriateness. Test requests and blood samples of clinical chemistry, immunoassay, hematology, glycated hemoglobin, coagulation and erythrocyte sedimentation rate test units were evaluated. Types of inappropriateness were evaluated as follows: improperly labelled samples, hemolysed, clotted specimen, insufficient volume of specimen and total request errors. Results: A total of 5,183,582 test requests from 1,035,743 blood collection tubes were considered. The total rejection rate was 0.65 %. The rejection rate of coagulation group was significantly higher (2.28%) than the other test groups (P < 0.001) including insufficient volume of specimen error rate as 1.38%. Rejection rates of hemolysis, clotted specimen and insufficient volume of sample error were found to be 8%, 24% and 34%, respectively. Total request errors, particularly, for unintelligible requests were 32% of the total for inpatients. Conclusions: The errors were especially attributable to unintelligible requests of inappropriate test requests, improperly labelled samples for inpatients and blood drawing errors especially due to insufficient volume of specimens in a coagulation test group. Further studies should be performed after corrective and preventive actions to detect a possible decrease in rejecting sample

Renal Biomarkers N-Acetyl-Beta-D-Glucosaminidase (NAG), Endothelin, and Their Application

WOS: 000449413600019The risk of acute kidney injury is rising due to aging in the world and with the increased usage of therapeutic agents and diagnostic interventions which are highly nephrotoxic. Kidneys, however, well tolerate with the injury, and with the late rise in nitrogenous waste products such as creatinine and BUN in the blood, the organ damage is underestimated. Biomarkers are being searched to find a more specific and sensitive one for kidney injury diagnosis like cardiac troponins (I and T) which is the gold standard in diagnosing acute coronary syndrome nowadays replaced the total creatine kinase and CK-MB. However, there is still no such a marker available to take place instead of creatinine. N-Acetyl-beta-Dglucosaminidase is a lysosomal enzyme that leaks into urine which is mainly originated from the proximal tubular cells. This enzyme is defined as being more specific and sensitive to renal tubular injury than creatinine especially with its isoenzymes and when combined with other renal biomarkers, for example, NGAL and Kim-1. N-Acetyl-beta-D-glucosaminidase is stable in urine, and the variation among individuals is minimal that the spot urine sample is adequate for the assay practically with colorimetric and spectrophotometric methods with its high reproducibility. Endothelins are paracrine hormones that stimulate myocardial contraction and other smooth muscle contraction such as uterus, bronchus, and stomach. They also promote vascular smooth muscle cell growth. Besides they stimulate secretion in kidney, liver, and adrenals. Endothelins are implicated in many pathophysiological conditions such as hypertension, myocardial infarctus, subarachnoidal hemorrhage, and kidney failure

Stability studies of common biochemical analytes in serum separator tubes with or without gel barrier subjected to various storage conditions

Introduction: The collected and shipped blood samples are exposed to a various extra-analytical factors prior to analysis. The aim of the study was to determine the stability of analytes in serum gel tubes and plain tubes exposed to a range of storage temperatures and times after centrifugation. Materials and methods: Fifteen healthy volunteers were recruited and venous blood was collected into four tubes, two with and two without gel separator. Analyzing the baseline samples in 30 min, all were stored at 4ºC or 24ºC for 6, 12, 18, 24, 30, 36, 48 and 72 hours and 1 week. Sixteen biochemi-cal anaytes were measured on each sample. Variations remained under the desirable bias conside-red as clinically insignificant. Results: On day three, most analytes remained stable including albumin, protein, creatinine, choles-terol, triglycerides, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), alanine aminot-ransferase (ALT), creatine kinase (CK), lactate dehydrogenase (LD) regardless of tube types. Gluco-se concentration decreased markedly (P = 0.001) beginning from the first hours of storage in plain serum. The stability maximized for the analytes including glucose, total bilirubin, urea nitrogen (BUN), uric acid stored at 4 ºC in gel tubes. Aspartate aminotransferase (AST) activity increased significantly (P = 0.002) up to 48-h, however bias was not significant clinically. High density lipoprotein (HDL) con-centration was stable in gel tubes at 24 ºC, in plain tubes at 4 ºC stored up to 36-h. Conclusion: Serum gel or non-gel tubes might be used interchangeably for 11 analytes chilled or at 24 ºC, whereas some restrictions must be applied for glucose, AST, BUN, HDL, and uric acid

The anti-inflammatory and antioxidant effects of pravastatin and nebivolol in rat aorta

Objective: The aim of this study was to investigate the effects of pravastatin and nebivolol in the atherosclerotic process including inflammation and oxidative stress in rat aorta

The anti-inflammatory and antioxidant effects of pravastatin and nebivolol in rat aorta

Objective: The aim of this study was to investigate the effects of pravastatin and nebivolol in the atherosclerotic process including inflammation and oxidative stress in rat aorta

Renal Dysfunction in Pediatric Thalassemia Major Patients and Evaluation of Urine NGAL Levels in Thalassemia

56th Annual Meeting of the American-Society-of-Hematology -- DEC 06-09, 2014 -- San Francisco, CAWOS: 000349233806006Amer Soc Hemato

Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors

Introduction: Preanalytical errors, along the process from the beginning of test requests to the admissions of the specimens to the laboratory, cause the rejection of samples. The aim of this study was to better explain the reasons of rejected samples, regarding to their rates in certain test groups in our laboratory. Materials and methods: This preliminary study was designed on the rejected samples in one-year period, based on the rates and types of inappropriateness. Test requests and blood samples of clinical chemistry, immunoassay, hematology, glycated hemoglobin, coagulation and erythrocyte sedimentation rate test units were evaluated. Types of inappropriateness were evaluated as follows: improperly labelled samples, hemolysed, clotted specimen, insufficient volume of specimen and total request errors. Results: A total of 5,183,582 test requests from 1,035,743 blood collection tubes were considered. The total rejection rate was 0.65 %. The rejection rate of coagulation group was significantly higher (2.28%) than the other test groups (P < 0.001) including insufficient volume of specimen error rate as 1.38%. Rejection rates of hemolysis, clotted specimen and insufficient volume of sample error were found to be 8%, 24% and 34%, respectively. Total request errors, particularly, for unintelligible requests were 32% of the total for inpatients. Conclusions: The errors were especially attributable to unintelligible requests of inappropriate test requests, improperly labelled samples for inpatients and blood drawing errors especially due to insufficient volume of specimens in a coagulation test group. Further studies should be performed after corrective and preventive actions to detect a possible decrease in rejecting sample

The role of TMPRSS6 gene variants in iron-related hematological parameters in Turkish patients with iron deficiency anemia

TMPRSS6 gene mutations can result in iron deficiency anemia (IDA) and cause an increased iron-regulatory hormone, hepcidin, levels. TMPRSS6 encodes a serine protease, matriptase-2, which functions as negative regulatory protein of hepcidin transcription. Thus, TMPRSS6 variations might be risk factors for IDA. The aim of the study was to investigate the association of rs855791, rs4820268, rs5756506, rs2235324, rs2413450, rs2111833, rs228919, and rs733655 SNPs in TMPRSS6 gene with IDA susceptibility and iron-related clinical parameters. The study consisted of 150 IDA patients and 100 healthy controls. We analyzed the genotype distributions by using Real-Time polymerase chain reaction (Real-Time PCR) technique. We did not find any statistically differences for all SNPs between patients and controls (P > 0.05). In IDA patients, variations rs855791 and rs2413450 were associated with increased RBC (P = 0.03) and TIBC (P = 0.04), respectively. Also, increased of TIBC for rs4820268 (P < 0.05). On the other hand, in control group, rs5756506 was associated with two parameters, Hb (P = 0.02) and Hct (P = 0.03). We did not find markedly hepcidin levels in IDA patients compared to controls (P = 0.32). Our findings suggest that TMPRSS6 variations may not be risk factors for IDA. However, TMPRSS6 polymorphisms are associated with increased many iron-related hematological parameters