Do Serum Creatinine Levels Show Clinically Significant Fluctuations on Serial Determinations on the Siemens Advia 1800 Analyzer?

Levitan, Daniel; Harper, Aaron; Sun, Yi; Carniello, Jose V. Scarpa; Momeni, Amir; Kagan, Joshua; Alexis, Herol; Eid, Ikram; Harris, Loretta; Marshal, Barbara; Tafani, Edlira; Pincus, Matthew R.

doi:10.1002/jcla.22012

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…Occasional CV values were obtained that were significantly higher than the mean such as 14.08 and 12.06 for ALT and AST, respectively (column 4, entries 2 and 3 in Table 1). This observation reflects a phenomenon that occurs frequently in studies on the reproducibility of values [3,4] higher values of CVs often are found for values that have low means. The ALT sample having the CV value of 14.08 had the following six values determined over the study's time course: 6, 7, 9,7,7,8 with a mean of 7.33 and a standard deviation of 1.03.…”

Section: Stabilities Of Individual Samplessupporting

confidence: 53%

“…In several prior studies, we examined the stabilities of a number of serum analytes included electrolytes [1], glucose [2], BUN [3] and creatinine [3,4] These studies were prompted by specific findings such as slow increases in sodium values on the same samples after ion selective electrode replacement [1], effects of storage of samples prior to analysis [5] and random error in borderline values of creatinine [4]. In view of several recent requests for repeat analysis of several serum enzyme levels, we have extended our studies as part of our quality assurance program to include these critical enzymes.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, it is known that ALT, a marker for acute liver disease including hepatitis, may be only marginally elevated in patients with hepatitis C, necessitating stable enzyme levels to be present in the event of re-assay [10]. This issue is the so-called "borderline value problem" encountered in borderline values for such analytes as creatinine [4], wherein values obtained for the same sample can alternate between normal or high causing difficulty in interpreting the result.…”

Section: Introductionmentioning

confidence: 99%

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Stability of values for the activities of critical enzymes assayed in serum

Bs¹,

Bs²,

Momeni³

et al. 2017

Clin Diagn Pathol

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Background: Assays for the activities of a set of enzymes in serum, i.e., alkaline phosphatase (ALP), alanine amino transferase (ALT), asparatate amino transferase (AST), creatine phosphokinase (CK), and lacatate dehydrogenase (LD) are critical in the diagnosis of a wide range of diseases. In view of reports that storage of some of these enzymes at 4 o C or lower results either in progressive irreversible enzyme inactivation (CK and LDH) or activation (ALP), and because re-assays for these enzymes are requested, we have undertaken to study the stabilities of these enzyme activities over time (6 days) at 4°C. Methods: Thirty patient samples, that were assayed for each of these enzyme activities and were stored at 4°C , were re-assayed on a Beckman-Coulter AU5800 analyzer. The mean values, standard deviations and coefficients of variation (CVs) were determined for each analyte in each sample over this time period. ANOVA analysis was performed for day-to-day variances for all samples to determine if the values obtained over the six day period were statistically the same.

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Section: Stabilities Of Individual Samplessupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stability of values for the activities of critical enzymes assayed in serum

Bs¹,

Bs²,

Momeni³

et al. 2017

Clin Diagn Pathol

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“…Imprecision in repeat determinations of specific samples can result in confusion concerning diagnosis. This applies especially to analyte values that are "borderline," i.e., that lie close to the lower or upper limit values of the reference range 4 . Imprecision in these cases can result in false positive or false negative test results leading to an incorrect diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Stability of Thyroid Function Test Analytes Whose Serum Levels Are Determined by Immunoassay

Christian

Minkowitz²,

Gabutan³

et al. 2023

MRAJ

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We have performed stability studies on thyroid function tests, i.e., T4, T3, free T4, free T3 and thyroid stimulating hormone (TSH), over a five-day period on the sera of ten patients. We find that the levels for each analyte were stable; the mean coefficients of variation (CV) ranged from 3.2 % for TSH to 8.7% for T4. ANOVA statistical analysis of group means for each analyte over the five-day period indicated that there was no statistically significant difference in these means, confirming the reproducibility of values. On the other hand, the CVs are significantly larger than those found in our prior stability studies for other critical analytes such as electrolytes (sodium, potassium, chloride, calcium). In addition, significant variations in values over the five-day period occurred for T4 which showed the largest variations in values of the five analytes studied. In one patient, the values ranged from a low of <10 ug/dL to over 14 ug/dL over the five-day period. A two-tailed t test comparing the mean CV for TSH with the mean CVs of the other four analytes showed that the mean CV for TSH was statistically significantly lower than that for the other four analytes indicating that the assay for TSH yield the most precise results. These results parallel those obtained in our prior electrolyte study that showed very low CVs for sodium, potassium and chloride and a significantly higher CV for calcium. Since approximately half of total serum calcium is bound to albumin and since very high percentages of T4 and T3 (≥99%) are bound to thyroid binding globulin and albumin, protein binding of these analytes may introduce a possible source of assay imprecision.

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Biopolymer Cooperation for Sustainable High‐Performance Oxidase‐Based Biosensing with the Simplest Possible Readout of Substrate Conversion

Soysa

Rattanopas

Teanphonkrang

et al. 2021

Adv Materials Technologies

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For sustainable high‐quality biosensor preparation, the biopolymers zein and gelatin are placed on Pt electrodes as base‐ and top‐coats, respectively, through simple drop‐and‐dry addition. The gelatin top‐coat of the biocompatible sandwich supports covalent external attachment of glucose oxidase (GOx), ensuring easy access of substrate to enzyme, while the lower, selectively permeable zein base‐coat protects electro‐oxidative detection of enzymically‐produced hydrogen peroxide from interferents. The functional cooperativity between gelatin‐GOx immobilization and molecular filtering by zein produced signal linearity up to 1 mm glucose, a sub‐µm practical detection limit, a rapid response time, a long shelf‐life, and excellent glucose analytical quality testing even with serum samples with intentionally elevated levels of interferents. This demonstrates for the first time the exceptional power of the cooperative action of two natural polymers in the ecofriendly improvement of a biosensor. The excellent performance of the novel biosensor design is confirmed here using GOx as a model, however, its application to other enzymes, antibodies, and DNA is feasible, offering economical biosensing while utilizing green functional materials. Moreover, the successful establishment of the cooperative dual biopolymer functionality on mass‐fabricated commercial screen‐printed electrode platforms verify the essential suitability of this methodology for portable clinical and personal health care monitoring.

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Do Serum Creatinine Levels Show Clinically Significant Fluctuations on Serial Determinations on the Siemens Advia 1800 Analyzer?

Abstract: Mild-to-moderate fluctuations in precision occur in successive serum creatinine determinations. The overwhelming majority of these fluctuations should not affect clinical decision making.

Cited by 4 publications

References 2 publications

Stability of values for the activities of critical enzymes assayed in serum

Stability of values for the activities of critical enzymes assayed in serum

Stability of Thyroid Function Test Analytes Whose Serum Levels Are Determined by Immunoassay

Biopolymer Cooperation for Sustainable High‐Performance Oxidase‐Based Biosensing with the Simplest Possible Readout of Substrate Conversion

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