Evaluation of the impact of delayed centrifugation on the diagnostic performance of serum creatinine as a baseline measure of renal function before antiretroviral treatment
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | Evaluation of the impact of delayed centrifugation on the diagnostic performance of serum creatinine as a baseline measure of renal function before antiretroviral treatment | |
| Creator | Chikomba, Chemedzai E. Padoa, Carolyn J. Tanyanyiwa, Donald | |
| Description | Background: The measurement of serum creatinine is a standard requirement of the medical management of people living with HIV. Renal dysfunction is common, both as a complication of HIV-infection and as a result of its treatment. The detection of abnormal renal function before the start of antiretroviral therapy will impact patient management and the outcome of treatment.Objectives: This study aimed to determine if a time delay in the centrifugation of serum samples affected the creatinine level and the estimated glomerular filtration rate as recorded on the analytical platforms used in the laboratory.Methods: Twenty-two (n = 22) HIV-positive, newly diagnosed and treatment-naïve patients were randomly recruited from Alexandra Health Clinic, Johannesburg, South Africa. Serum samples were centrifuged at six time intervals following receipt of the sample viz. 4 h (baseline), 6 h, 24 h, 48 h, 72 h and 96 h. Creatinine concentrations were measured on the Roche platform utilising the enzymatic and kinetic Jaffe methods. Whole blood samples were also analysed with the Abbott i-STAT point-of-care instrument. The estimated glomerular filtration rate was calculated using the Cockcroft Gault, CKD–Epidemiology Collaboration and Modified Diet and Renal Disease v3/4 equations.Results: At baseline ( 4 h) there was good agreement between the enzymatic and kinetic Jaffe methods: bias 1.7 µmol/l. The enzymatic and i-STAT creatinine concentrations were stable over 96 h viz. changes of 1.8% and 5.7%. However, from 24 h onwards agreement between the enzymatic and kinetic Jaffe methods was poor with the latter measuring 43.7 µmol/l higher than the enzymatic method at 96 h. Creatinine concentrations measured with the kinetic Jaffe method increased significantly in samples centrifuged after 6 h (p 0.001, 61.7% change), and resulted in a 95% decline in eGFR at 96 h as determined with the CKD–Epidemiology Collaboration equation.Conclusion: The analysis of serum creatinine using the isotope dilution mass spectrometry traceable kinetic Jaffe method is unreliable if performed on samples centrifuged ≥ 6 h after collection. The raised creatinine concentration can affect clinical decisions such as renal functional assessment, choice of antiretroviral drug or regimen, and the dose and frequency of medication. | |
| Publisher | AOSIS | |
| Date | 2020-07-16 | |
| Identifier | 10.4102/sajhivmed.v21i1.1056 | |
| Source | Southern African Journal of HIV Medicine; Vol 21, No 1 (2020); 15 pages 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/1056/1916
https://sajhivmed.org.za/index.php/hivmed/article/view/1056/1915
https://sajhivmed.org.za/index.php/hivmed/article/view/1056/1917
https://sajhivmed.org.za/index.php/hivmed/article/view/1056/1914
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