title: Focusing on the clinical impact of standardization of creatinine measurements: a report by the EFCC Working Group on Creatinine Standardization.
abstract: The recent campaign for standardization of creatinine measurements has been promoted to allow the widespread use of formulas for estimating the glomerular filtration rate (GFR). However, studies on trueness verification and measurement interferences still show disappointing interassay variation of serum creatinine results. Creatinine recalibration has major clinical consequences. In particular, in pediatrics where reference ranges for serum and plasma creatinine are low, calculation of the GFR is problematic when based on alkaline picrate methods because of method non-specificity and the lack of appropriate GFR estimating formulas. Therefore, enzymatic creatinine assays are preferred. In the near future, cystatin C might offer an interesting alternative for GFR estimation. For the calculation of drug doses, the Modification of Diet in Renal Disease study formula generally offers reliable data. However, attention has to be paid to the elderly. Also, the calculation of the Model for End-Stage Liver Disease score, which is used to prioritize patients for liver transplantation, may significantly be influenced by recalibration of creatinine assays. Creatinine restandardization may also affect the current guidelines for referral of chronic kidney disease patients to nephrologists.
authors.affiliation: Department of Clinical Chemistry, University Hospital, Gent, Belgium. Joris.delanghe@ugent.be
authors.forename: Joris R
authors.initials: JR
authors.lastname: Delanghe
authors.forename: Christa
authors.initials: C
authors.lastname: Cobbaert
authors.forename: Aimo
authors.initials: A
authors.lastname: Harmoinen
authors.forename: Rob
authors.initials: R
authors.lastname: Jansen
authors.forename: Päivi
authors.initials: P
authors.lastname: Laitinen
authors.forename: Mauro
authors.initials: M
authors.lastname: Panteghini
mesh_terms: D001774:Blood Chemical Analysis / Q000592:standards*; D003404:Creatinine / Q000097:blood*; D054796:Drug Dosage Calculations; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D016031:Liver Transplantation / Q000592:standards; D012015:Reference Standards; D058028:Research Report
chemical_list: D003404:Creatinine