Frontiers in Medicine (Jan 2024)
Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice
- Regina Demlova,
- Sarka Kozakova,
- Sarka Kozakova,
- Michal Rihacek,
- Michal Rihacek,
- Michal Rihacek,
- Dana Buckova,
- Dana Buckova,
- Katerina Horska,
- Katerina Horska,
- Ondrej Wiewiorka,
- Ondrej Wiewiorka,
- Lubos Boucek,
- Iveta Selingerova,
- Iveta Selingerova,
- Martina Podborska,
- Martina Podborska,
- Alena Korberova,
- Alena Korberova,
- Alena Mikuskova,
- Alena Mikuskova,
- Jiri Starha,
- Jiri Starha,
- Miroslava Benovska,
- Miroslava Benovska,
- Martin Radina,
- Martin Radina,
- Martin Radina,
- Michal Richter,
- Lenka Zdrazilova Dubska,
- Lenka Zdrazilova Dubska,
- Lenka Zdrazilova Dubska,
- Dalibor Valik,
- Dalibor Valik,
- Dalibor Valik,
- Dalibor Valik
Affiliations
- Regina Demlova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
- Sarka Kozakova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
- Sarka Kozakova
- Department of Pharmacy, University Hospital Brno, Brno, Czechia
- Michal Rihacek
- Diagnostic and Therapeutic Centre, Emergency Services Department, University Hospital Brno, Masaryk University, Brno, Czechia
- Michal Rihacek
- Department of Laboratory Medicine, University Hospital Brno, Masaryk University, Brno, Czechia
- Michal Rihacek
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Dana Buckova
- Department of Laboratory Medicine, University Hospital Brno, Masaryk University, Brno, Czechia
- Dana Buckova
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Katerina Horska
- Department of Pharmacy, Clinical Pharmacy Services Unit, University Hospital Brno, Brno, Czechia
- Katerina Horska
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Masaryk University, Brno, Czechia
- Ondrej Wiewiorka
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Ondrej Wiewiorka
- Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia
- Lubos Boucek
- Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia
- Iveta Selingerova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
- Iveta Selingerova
- Department of Mathematics and Statistics, Faculty of Science, Masaryk University, Brno, Czechia
- Martina Podborska
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Martina Podborska
- Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia
- Alena Korberova
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Alena Korberova
- Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia
- Alena Mikuskova
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Alena Mikuskova
- 0Department of Pediatric Hematology and Biochemistry, University Hospital Brno, Brno, Czechia
- Jiri Starha
- 1Department of Pediatrics, Pediatric Nephrology Unit, University Hospital Brno, Brno, Czechia
- Jiri Starha
- 2Faculty of Medicine, Masaryk University, Brno, Czechia
- Miroslava Benovska
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Miroslava Benovska
- Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia
- Martin Radina
- 3Research Unit for Rare Diseases, Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czechia
- Martin Radina
- 4General Teaching Hospital, Prague, Czechia
- Martin Radina
- 5Spadia Laboratories, Central Reference Lab, Division of Clinical Biochemistry, Ostrava, Czechia
- Michal Richter
- 5Spadia Laboratories, Central Reference Lab, Division of Clinical Biochemistry, Ostrava, Czechia
- Lenka Zdrazilova Dubska
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
- Lenka Zdrazilova Dubska
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Lenka Zdrazilova Dubska
- Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia
- Dalibor Valik
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
- Dalibor Valik
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
- Dalibor Valik
- Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia
- Dalibor Valik
- 6Department of Pediatric Oncology, University Hospital Brno, Brno, Czechia
- DOI
- https://doi.org/10.3389/fmed.2023.1236948
- Journal volume & issue
-
Vol. 10
Abstract
BackgroundAssessment of kidney function in emergency settings is essential across all medical subspecialties. Daily assessment of patient creatinine results from emergency medical services showed that some deviated from expected values, implying drug-related interference.MethodsReal-time clinical evaluation of an enzyme method (Roche CREP2) in comparison with the Jaffé gen. 2 method (Roche CREJ2) was performed. During the period of December 2022 and January 2023, we analyzed 8,498 patient samples, where 5,524 were heavily medicated STAT patient specimens, 500 were pediatric specimens, and 2,474 were from a distant general population in a different region using the same methods.ResultsIn 109 out of 5,524 hospital specimens (1.97%, p < 0.001), the CREP2 value was apparently (25% or more) lower than CREJ2. Suspect interfering medication was found in a sample of 43 out of 46 reviewed patients where medication data were available. This phenomenon was not observed in the general population.ConclusionIn a polymedicated urgent care hospital population, a creatinine enzyme method produces unreliable results, apparently due to multiple drug-related interferences.
Keywords
