The Effect of Bilirubin on Laboratory Investigations on Serum Creatinine: A Comparison Study Between Jaffe Reaction and Creatinase Enzymatic Method With Creatinine in Phosphate Buffered Saline Solution and Serum

Year 2022, Volume: 12 Issue: 1, 11 - 17, 30.03.2022

Ruchira Kumari Dissanayake Kamburawala Kankanamgee Pramodya Tharaki Ranaweera Pathiranage Dias A.m.b. Priyadarshani

https://doi.org/10.33808/clinexphealthsci.714844

Cited By: 2

Abstract

Objective: To determine the creatinine concentration in phosphate buffered saline solution and serum with different bilirubin concentrations
using Jaffe reaction and Creatinase method.
Methods: In Phase 1, creatinine and bilirubin concentrations in the dilution series were 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 mg/dL and 0, 3, 6, 9, 12, 15,
18, 21, 24, 27, 30 mg/dL, respectively. Each creatinine concentration was spiked with eleven bilirubin concentrations used in Phase 1. In Phase
2, serum with creatinine values 0.51, 2.41 and 7.33 mg/dL were spiked with 11 bilirubin concentrations. The total bilirubin, creatinine by Jaffe
reaction and Creatinase method were measured.
Results: In Phase 1, Jaffe reaction showed a significant underestimation up to creatinine concentration of 2 mg/dL at all bilirubin concentrations.
From 3 mg/dL onwards, a significant overestimation was observed with high bilirubin concentrations. In Phase 2, Creatinase method gave no
significant underestimation in serum with 0.51 mg/dL of creatinine. But Jaffe reaction showed a significant underestimation from bilirubin
concentration of 7.18 mg/dL. In serum with 2.41 mg/dL creatinine, Creatinase and Jaffe methods gave significant underestimations from
bilirubin concentrations of 9.05 and 5.64 mg/dL, respectively. In serum of 7.33 mg/dL creatinine, significant underestimations were given from
bilirubin levels of 3.6 and 8.18 mg/dL by Creatinase and Jaffe methods, respectively.
Conclusion: In normal to moderately high bilirubin concentrations the Creatinase method is more accurate than the Jaffe method in all
creatinine concentrations used. At high creatinine concentrations Creatinase method gave significant underestimations which increased with
bilirubin concentration.

Keywords

Bilirubin, Creatinine, Jaffe reaction, Creatinase method

Supporting Institution

University of Sri Jayewardenepura

Project Number

MLS/19/17

Thanks

Mrs. Thilini Wijeratne

References

• [1] Vasudevan DM, Sreekumari S, Vaidyanathan K. Textbook of Biochemistry for Medical Students. 7th ed: Jaypee Brothers Medical Publishers (P) Ltd; 2013.
• [2] Lolekha PH, Jaruthunyaluck S, Srisawasdi P. Deproteinization of serum: Another best approach to eliminate all forms of bilirubin interference on serum creatinine by the kinetic Jaffe reaction. J Clin Lab Anal 2001;15:116–121.
• [3] Kroll MH, McCudden CR. Endogenous Interferences in Clinical Laboratory Tests. Walter de Gruyter GmbH; 2013.
• [4] Cobbaert CM, Baadenhuijsen H, Weykamp CW. Prime time for enzymatic creatinine methods in pediatrics. Clin Chem 2009;55(3): 549-558.
• [5] Marakala V, Avinash SS, Shivashankara AR, Malathi M, Kumar A. Serum creatinine assay: enzymatic vs kinetic Jaffe’s Method. J Evol Med Dent Sci 2012;1(4):328–334.
• [6] Robert J, McEnroe P, Burritt P, Powers P, Douglas W, Rheinheimer MT, Brian H, Wallace P. Interference Testing in Clinical Chemistry; Approved Guideline. 2nd ed: Clinical and Laboratory Standards Institute; 2005.
• [7] O’Leary N, Pembroke A, Duggan PF. A simplified procedure for eliminating the negative interference of bilirubin in the Jaffe reaction for creatinine. Clin Chem 1992;38(9):1749–1751.
• [8] Dimeski G. Interference testing. Clin Biochem Rev 2008;29(1): 43-48.
• [9] James O. Westgard, Elsa F. Quam. Interference and Recovery Experiments Westgard QC. 2018
• [10] Chung H, Chun S, Min W. Creatinine determination with minimized interference. J Lab Med Qual Assur 2008;30(2):229– 231.
• [11] Piyophirapong S, Wongtiraporn W, Sribhen K. Factitious results in clinical chemistry tests caused by common endogenous interferents. Siriraj Med J. 2010;62:185–188.
• [12] Owen LJ, Wear JE, Keevil BG. Validation of a liquid chromatography tandem mass spectrometry assay for serum creatinine and comparison with enzymatic and Jaffe methods. Ann Clin Biochem 2006;43:118-123.
• [13] Peake M, Whiting M. Measurement of serum creatinine – Current status and future goals. Clin Biochem Rev 2006;27(4):173–184.
• [14] Yoshizawa T. Handbook of Optical Metrology: Principles and Applications. 2nd ed: CRC Press; 2017.
• [15] Schmidt RL, Straseski JA, Raphael KL, Adams AH, Lehman CM. A Risk assessment of the Jaffe vs enzymatic method for creatinine measurement in an outpatient population. PLoS One 2015; DOI:10.1371/journal.pone.0143205
• [16] Lolekha PH, Sritong N. Comparison of techniques for minimizing interference of bilirubin on serum creatinine determined by the kinetic Jaffé reaction. J Clin Lab Anal 1994;8:391–399.
• [17] Knapp ML, Mayne PD. Development of an automated kinetic Jaffé method designed to minimise bilirubin interference in plasma creatinine assays. Clin Chim Acta 1987;168(2):239– 246.