Chemistry Testing on Plasma Versus Serum Samples in Dialysis Patients: Clinical and Quality Improvement Implications

Abstract

Plasma samples collected in tubes containing separator gels have replaced serum samples for most chemistry tests in many hospital and commercial laboratories. Use of plasma samples for blood tests in the dialysis population eliminates delays in sample processing while waiting for clotting to complete, laboratory technical issues associated with fibrin formation, repeat sample collection, and patient care issues caused by delay of results because of incompletely clotted specimens. Additionally, a larger volume of plasma is produced than serum for the same amount of blood collected. Plasma samples are also acceptable for most chemical tests involved in the care of patients with ESRD. This information becomes very important when United States regulatory requirements for ESRD inadvertently limit the type of sample that can be used for government reporting, quality assessment, and value-based payment initiatives. In this narrative, we summarize the renal community experience and how the subsequent resolution of the acceptability of phosphorus levels measured from serum and plasma samples may have significant implications in the country's continued development of a value-based Medicare ESRD Quality Incentive Program.

Clinical Pharmacokinetics and Pharmacodynamics of Febuxostat

“…The uricase method is suitable for measuring urate in plasma, serum or urine [165]. As mentioned in Chapter 1, serum and plasma measurements of urate can be used interchangeably without limitations [42,187]. For consistency, serum urate is used from this point onwards.…”

Moroccan Bee Bread Improves Biochemical and Histological Changes of the Brain, Liver, and Kidneys Induced by Titanium Dioxide Nanoparticles

“…It is recommended for several biochemical analyses to use heparinized plasma, because firstly plasma constituents reflect better the pathologic state than serum [ 34 ] and secondly the volume of heparinized plasma is higher by 15% to 20% than serum obtained from the same volume of blood [ 35 ]. For that, blood samples were collected from each rat on day 30 by retro-orbital plexus using capillary tubes and heparin as anticoagulant; then, the blood samples were centrifuged at 4000 rpm for 10 min at 4°C, and the plasma samples obtained were conserved at -20°C until analysis.…”

Certification of Ca, Mg, and K in human plasma reference material using isotope dilution inductively coupled plasma mass spectrometry

“…Human serum is one of the most widely used biological fluids for diagnostic purposes in clinical analysis, while the use of plasma is gaining popularity, especially for patients undergoing anticoagulant treatments. 6 Metrological traceability is one of the most important criteria for ensuring comparable and reliable results in clinical analysis. 7,8 To meet such a requirement, National Metrology Institutes (NMIs) worldwide have developed certified reference materials (CRMs) for the analysis of various analytes of clinical importance.…”