title: LC-MS/MS Method for Serum Creatinine: Comparison with Enzymatic Method and Jaffe Method.
abstract: Accurate quantification of creatinine (Cre) is important to estimate glomerular filtration rate (GFR). Differences among various methods of Cre quantification were previously noted. This study aims to develop a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for serum Cre and compare this method with clinical routine methods. LC-MS/MS analysis was performed on API 4000 triple quadrupole mass spectrometer coupled with an Agilent 1200 liquid chromatography system. After adding isotope-labeled Cre-d3 as internal standard, serum samples were prepared via a one-step protein precipitation with methanol. The LC-MS/MS method was compared with frequently used enzymatic method and Jaffe method. This developed method, with a total run time of 3 min, had a lower limit of quantification of 4.4 μmol/L, a total imprecision of 1.15%-3.84%, and an average bias of 1.06%. No significant matrix effect, carryover, and interference were observed for the LC-MS/MS method. The reference intervals of serum Cre measured by LC-MS/MS assay were 41-79 μmol/L for adult women, and 46-101 μmol/L for adult men. Using LC-MS/MS as a reference, the enzymatic method showed an average bias of -2.1% and the Jaffe method showed a substantial average bias of 11.7%. Compared with the LC-MS/MS method, significant negative bias was observed for the enzymatic and Jaffe methods in hemolytic and lipimic samples. We developed a simple, specific, and accurate LC-MS/MS method to analyze serum Cre. Discordance existed among different methods.
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Meixian
authors.initials: M
authors.lastname: Ou
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Department of Clinical Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Yunxiao
authors.initials: Y
authors.lastname: Song
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Shuijun
authors.initials: S
authors.lastname: Li
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Gangyi
authors.initials: G
authors.lastname: Liu
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Jingying
authors.initials: J
authors.lastname: Jia
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Menqi
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Department of Clinical Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Haichen
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Shanghai Clinical Research Center, Chinese Academy of Sciences, Shanghai, China; Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Yu
mesh_terms: D002853:Chromatography, Liquid / Q000379:methods*; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D053719:Tandem Mass Spectrometry / Q000379:methods*
chemical_list: D003404:Creatinine