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Ferry N, Caillette A, Goudable J, Denicola C, Pozet N
Creatinine determination in peritoneal dialysis: what method should be used?
Nephrol Dial Transplant (Nov) 11:2282-2287 1996
There are 3 major ways of measuring creatinine: the Jaffe alkaline picrate colorimetric method, enzymatic methods, and HPLC. The purpose of the investigation was to determine the influence of assay method on determination of creatinine clearance or lean body mass estimation in CAPD patients.
It was found that glucose interfered with both the Jaffe and the enzymatic method, but not with HPLC, of course. This is contrary to a previous report claiming that the enzymatic method is not affected by dialysate glucose levels. In general, the Jaffe reaction overestimated creatinine versus the enzymatic method or HPLC in plasma, but not in urine or dialysate. Using creatinine kinetics, the mean lean body mass (47 liter) was no significantly higher than when using the enzymatic method (44 liters p=NS, but a trend present) but substantially and significantly higher than when using HPLC (41 liters, p < 0.05)
Comment: The Jaffe method with a correction factor should be used to analyze dialysate glucose levels; one should not assume that the enzymatic method is immune to the effects of dialysate glucose. The Jaffe method may result in LBM determinations that are higher than if done with HPLC. (John T. Daugirdas, M.D., University of Illinois at Chicago)
The full text of this abstract is available from Oxford Press at this site.
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