Creatinine reference values in ELBW infants: impact of quantification by Jaffe or enzymatic method

Authors: Allegaert, Karel1; Kuppens, Maike2; Mekahli, Djalila3; Levtchenko, Elena3; Vanstapel, Florent4; Vanhole, Christine4; van den Anker, John N.

Source: Journal of Maternal-Fetal and Neonatal Medicine, Volume 25, Number 9, September 2012 , pp. 1678-1681(4)

Publisher: Informa Healthcare

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Abstract:

Objective: Serum creatinine (Scr) reflects to a certain extent glomerular filtration rate in neonates, but postnatal observations also depends on the technique used to quantify Scr (Jaffe colorimetry or enzymatic quantification). Methods: In an attempt to quantify differences between these techniques, we compared postnatal Scr trends in two consecutive cohorts of extremely low birth-weight (ELBW) neonates before and following a switch from uncompensated Jaffe to enzymatic Scr quantification. Postnatal Scr (Days 1, 2, 3, 4, 5, 6, 7, 8, 9, 14, 21, 28, and 42) in 151 ELBW neonates (uncompensated Jaffe) was compared to 116 more recently admitted ELBW neonates (enzymatic). Results: Although clinical characteristics were similar between both cohorts, median postnatal Jaffe Scr values were significantly higher compared to enzymatic quantification (all days, at least p < 0.001) throughout postnatal life. While both cohorts displayed a similar trend with an initial increase with a Scr peak on Days 3 and 4 and a subsequent decrease, the difference in within-day median values fluctuated between 11 and 24 mmol.L−1. There is neither fixed nor relative difference in Scr between both techniques. Conclusions: When using Scr to estimate renal function in ELBW neonates, clinicians should in addition to the postnatal changes and other covariates of renal function, also consider the technique applied. We provide reference values and comparison between both techniques.

Keywords: Biomarker; creatinine values; ELBW neonates; enzymatic; Jaffe

Document Type: Research article

DOI: http://dx.doi.org/10.3109/14767058.2012.657277

Affiliations: 1: 1Neonatal Intensive Care Unit, Leuven, Belgium 2: 2Department of Paediatrics, Leuven, Belgium 3: 3Department of Paediatric Nephrology, Leuven, Belgium 4: 4Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium

Publication date: 2012-09-01

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