Recommendations for improving serum creatinine measurement: A report from the Laboratory Working Group of the National Kidney Disease Education Program

Gary L. Myers, W. Greg Miller, Josef Coresh, James Fleming, Neil Greenberg, Tom Greene, Thomas Hostetter, Andrew S. Levey, Mauro Panteghini, Michael Welch, John H. Eckfeldt

Research output: Contribution to journalArticle

Abstract

Background: Reliable serum creatinine measurements in glomerular filtration rate (GFR) estimation are critical to ongoing global public health efforts to increase the diagnosis and treatment of chronic kidney disease (CKD). We present an overview of the commonly used methods for the determination of serum creatinine, method limitations, and method performance in conjunction with the development of analytical performance criteria. Available resources for standardization of serum creatinine measurement are discussed, and recommendations for measurement improvement are given. Methods: The National Kidney Disease Education Program (NKDEP) Laboratory Working Group reviewed problems related to serum creatinine measurement for estimating GFR and prepared recommendations to standardize and improve creatinine measurement. Results: The NKDEP Laboratory Working Group, in collaboration with international professional organizations, has developed a plan that enables standardization and improved accuracy (trueness) of serum creatinine measurements in clinical laboratories worldwide that includes the use of the estimating equation for GFR based on serum creatinine concentration that was developed from the Modification of Diet in Renal Disease (MDRD) study. Conclusions: The current variability in serum creatinine measurements renders all estimating equations for GFR, including the MDRD Study equation, less accurate in the normal and slightly increased range of serum creatinine concentrations [-1 · (1.73 m2)-1]. Many automated routine methods for serum creatinine measurement meet or exceed the required precision; therefore, reduction of analytical bias in creatinine assays is needed. Standardization of calibration does not correct for analytical interferences (nonspecificity bias). The bias and nonspecificity problems associated with some of the routine methods must be addressed.

Original languageEnglish (US)
Pages (from-to)5-18
Number of pages14
JournalClinical Chemistry
Volume52
Issue number1
DOIs
StatePublished - Jan 2006

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Kidney Diseases
Creatinine
Education
Serum
Glomerular Filtration Rate
Standardization
Diet Therapy
Nutrition
Clinical laboratories
Kidney
Public health
Chronic Renal Insufficiency
Calibration
Assays
Public Health

ASJC Scopus subject areas

  • Clinical Biochemistry

Cite this

Recommendations for improving serum creatinine measurement : A report from the Laboratory Working Group of the National Kidney Disease Education Program. / Myers, Gary L.; Miller, W. Greg; Coresh, Josef; Fleming, James; Greenberg, Neil; Greene, Tom; Hostetter, Thomas; Levey, Andrew S.; Panteghini, Mauro; Welch, Michael; Eckfeldt, John H.

In: Clinical Chemistry, Vol. 52, No. 1, 01.2006, p. 5-18.

Research output: Contribution to journalArticle

Myers, GL, Miller, WG, Coresh, J, Fleming, J, Greenberg, N, Greene, T, Hostetter, T, Levey, AS, Panteghini, M, Welch, M & Eckfeldt, JH 2006, 'Recommendations for improving serum creatinine measurement: A report from the Laboratory Working Group of the National Kidney Disease Education Program', Clinical Chemistry, vol. 52, no. 1, pp. 5-18. https://doi.org/10.1373/clinchem.2005.0525144
Myers, Gary L. ; Miller, W. Greg ; Coresh, Josef ; Fleming, James ; Greenberg, Neil ; Greene, Tom ; Hostetter, Thomas ; Levey, Andrew S. ; Panteghini, Mauro ; Welch, Michael ; Eckfeldt, John H. / Recommendations for improving serum creatinine measurement : A report from the Laboratory Working Group of the National Kidney Disease Education Program. In: Clinical Chemistry. 2006 ; Vol. 52, No. 1. pp. 5-18.
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