title: Limitations of compensated Jaffe creatinine assays in cirrhotic patients.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Laboratoire de Biochimie, CHRU Montpellier, France.
authors.forename: Nils
authors.initials: N
authors.lastname: Kuster
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Bargnoux
authors.forename: Georges-Philippe
authors.initials: GP
authors.lastname: Pageaux
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cristol
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000581:Amidohydrolases / Q000378:metabolism; D003404:Creatinine / Q000032:analysis / Q000097:blood* / Q000378:metabolism; D055316:Cystatin C / Q000097:blood*; D058625:End Stage Liver Disease / Q000097:blood / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D015312:Hemodialysis Solutions / Q000737:chemistry; D006801:Humans; D007201:Indicator Dilution Techniques; D008103:Liver Cirrhosis / Q000097:blood* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000209:etiology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C; D015312:Hemodialysis Solutions; D003404:Creatinine; D000581:Amidohydrolases; C019946:creatininase