Ethamsylate (Dicynone®) Interference in Determination of Serum Creatinine, Uric Acid, Triglycerides, and Cholesterol in Assays Involving the Trinder Reaction; In Vivo and In Vitro

Dastych, Milan; Wiewiorka, Ondřej; Beňovská, Miroslava

doi:10.7754/clin.lab.2013.130902

Cited by 13 publications

(9 citation statements)

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“…In addition to the calcium dobesilate highlighted in this article, there are also ethamsylate, phenolic sulfoethylamine, acetaminophen, ascorbic acid, catecholamine, aspirin, dopamine, analgin, and rifampicin detection inferenced by color development 17‐20 . Trinder's reaction involves not only creatinine but also uric acid (UA), triglyceride (TG), cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), etc 13,21 . many clinical drugs' interference tests are included in the performance evaluation of a detected item, but cannot cover all kinds of drugs.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20] Trinder's reaction involves not only creatinine but also uric acid (UA), triglyceride (TG), cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), etc. 13,21 many clinical drugs' interference tests are included in the performance evaluation of a detected item, but cannot cover all kinds of drugs. When judging test results, clinicians need to analyze the patient's condition from many aspects, and it is necessary to integrate multiple items of the same clinical significance for comparison so as to reach a more scientific conclusion.…”

Section: Discussionmentioning

confidence: 99%

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A new method for anti‐negative interference of calcium dobesilate in serum creatinine enzymatic analysis

Shen

Chen

Cao

2021

Clinical Laboratory Analysis

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Background Serum creatinine is a widely used biomarker for evaluating renal function. Sarcosine oxidase enzymatic (SOE) analysis is currently the most widely used method for the detection of creatinine. This method was negatively interfered with by calcium dobesilate, causing pseudo‐reduced results. The aim of this study was to explore a new method to alleviate the negative interference of this drug on creatinine detection. Method We formulated eight drug concentrations and 12 creatinine concentrations from serum. The SOE method, the new method, and the Jaffe method were used for detection in five systems. Creatinine biases were analyzed under the conditions with or without the interference of calcium dobesilate, at consistent or inconsistent creatinine concentrations. Creatinine concentrations were also analyzed at three medical decision levels (MDLs). Results Calcium dobesilate had negative interference in creatinine SOE analysis. With the increase in calcium dobesilate concentrations, the negative bias increases. The new BG method showed an anti‐negative interference effect. In the Roche system, the BG method reduced the negative bias from −71.11% to −16.7%. In the Abbott system, bias was reduced from −45.15% to −2.74%. In the Beckman system, the bias was reduced from −65.36% to −7.58%. In the Siemens system, the bias was reduced from −58.62% to −7.58%. In the Mindray system, the bias was reduced from −36.29% to −6.84%. Conclusion The new method alleviated the negative interference of calcium dobesilate in creatinine SOE detection. The negative bias could be reduced from −60% or −70% to less than −20%.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A new method for anti‐negative interference of calcium dobesilate in serum creatinine enzymatic analysis

Shen

Chen

Cao

2021

Clinical Laboratory Analysis

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“…For the remaining samples, the observed differences may be partially attributable to systemic differences between different reagents or other unknown interference factors in the serum samples. A number of substances may interfere with creatinine quanti cation using enzymatic assays [24][25][26][27][28][29]. For some patients with large deviating Cr-R and Cr-C assay results who did not have detectable serum CaD, we evaluated the patient's medical records and compared the creatinine levels with those determined by the reference method and identi ed ten cases where this discrepancy may have been caused by the presence of etamsylate.…”

Section: Discussionmentioning

confidence: 99%

“…For some patients with large deviating Cr-R and Cr-C assay results who did not have detectable serum CaD, we evaluated the patient's medical records and compared the creatinine levels with those determined by the reference method and identi ed ten cases where this discrepancy may have been caused by the presence of etamsylate. Etamsylate is known to interfere with enzymatic creatinine assays [28][29]. The Cr-R assay also solved the problem of interference by etamsylate, and generally gave more accurate serum creatinine results in these cases.…”

Section: Discussionmentioning

confidence: 99%

Multicentre Evaluation of a Newly Developed Anti-Calcium Dobesilate-Enzymatic Creatinine Assay Based on Real-World Data in China

Guo¹,

Hou²,

Lu³

et al. 2020

Preprint

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BackgroundPreviously, we reported that calcium dobesilate (CaD), a vasoprotective agent mainly used for diabetic retinopathy, negatively interferes with enzymatic creatinine assays. Anewly developed enzymatic creatinine assay, the “Cr-R assay”, is commercially available and claims to have no interference from CaD. This study aimed to verify the performance of the Cr-R assay on clinical samples and to investigate the degree of CaD interference in a multicentre, real-world study.MethodsThe precision and accuracy ofthe Cr-R assay was evaluated in 23 hospitals in different regions of China. Interference was then calculated both in vitro and in clinical samples. Samples with potential interference were screened based on the different creatinine results between Cr-R and the creatinine assays commonly used in each participating hospital (Cr-C). Interference was confirmed by determining serum CaD concentration by directly using ultra-performance liquid chromatography (UPLC) methodand by assessing the “true” creatinine levels using the standard isotope dilution mass spectrometry (ID-MS/MS) method. ResultsTheprecision and bias and anti-interference ability of Cr-R assay on most platforms fulfilled the specification criteria. In the clinical setting, 67,469 samples were tested in 23 centres, and CaD concentration was measured in 818 samples, of which 257 contained CaD, accounting for 0.38% of the total and 31% of screened patients. In these 257 cases, the median CaD concentration was 11.356 (range, 1.350–121.519; IQR, 7.162–21.175) μg/mL. Creatinine levels measured using Cr-C assay were up to 35.1% (95%CI, 37.9–32.4 %; P < 0.001) lower than the “real” creatinine levels using the ID-MS/MSmethod. For Cr-R reagent, the average bias from the reference method was -6.2% (95%CI, -7.9–4.6%; P < 0.001), ranging from -17.9% to 7.1%.ConclusionsMulticentre tests confirmed that the precision, bias, and anti-CaD ability of the Cr-R assay met clinical needs. The prevalence of CaD interference should be considered when performing clinical enzymatic creatinine measurements.Other manufacturers should improve the anti-interference performance of creatinine reagents.

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“…With the application of a number of alternative chromogenic materials, such as 2,4-dichlorophenol, the sensitivity of this method has been improved significantly. However, due to the poor substrate specificity of catalytic peroxidase for the Trinder reaction, multiple substances, such as ascorbic acid [ 1 , 2 ], etamsylate [ 3 ], N-acetylcysteine [ 4 ], and bilirubin [ 5 ], can interfere with the assay’s results. Recently, we confirmed that the medication calcium dobesilate produces significant negative interferences with the determination of creatinine using sarcosine oxidase-based assays, and the extent of interference differs significantly among the different assay systems [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Negative interferences by calcium dobesilate in the detection of five serum analytes involving Trinder reaction-based assays

et al. 2018

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Previously, we reported the strong negative interference of calcium dobesilate, a vasoprotective agent, in creatinine assays involving the Trinder reaction. It is hypothesized that a similar effect occurs in the detection of uric acid (UA), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). The interferences of calcium dobesilate during the detection of the five serum analytes were investigated on automated systems/analysers, and the effects were compared among eight different assay systems for each analyte. A calcium dobesilate standard was added into two sets of the blank serum pools of each analyte at final concentrations of 0, 2, 4, 8, 16, 32, and 64 μg/mL. The percentage deviation of each analyte value was calculated between each drug concentration and the drug-free samples. The clinically acceptable error levels for UA, TC, TG, HDL-C, and LDL-C were defined as ±4.87%, ±4.1%, ±9.57%, ±5.61%, and ±5.46%, respectively. The observed interference was concentration dependent for each analyte. In the presence of 16 μg/mL calcium dobesilate, which was within the therapeutic range, all seven Trinder reaction-based UA assay systems, two TG assay systems, two HDL-C assay systems and one TC assay system exhibited negative drug interferences. Calcium dobesilate negatively interferes with the detection of UA, TG, TC, and HDL-C in assay systems based on the Trinder reaction. The effect was most significant in UA and TG detection.

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Ethamsylate (Dicynone®) Interference in Determination of Serum Creatinine, Uric Acid, Triglycerides, and Cholesterol in Assays Involving the Trinder Reaction; In Vivo and In Vitro

Cited by 13 publications

References 0 publications

A new method for anti‐negative interference of calcium dobesilate in serum creatinine enzymatic analysis

A new method for anti‐negative interference of calcium dobesilate in serum creatinine enzymatic analysis

Multicentre Evaluation of a Newly Developed Anti-Calcium Dobesilate-Enzymatic Creatinine Assay Based on Real-World Data in China

Negative interferences by calcium dobesilate in the detection of five serum analytes involving Trinder reaction-based assays

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