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An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages

Cilt: 36 Sayı: 2026 7 Temmuz 2026
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An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages

Öz

Aim: This study aims to compare estimated Glomerular Filtration Rate (eGFR) values calculated using Jaffe and enzymatic creatinine measurement methods across different stages of chronic kidney disease (CKD), to assess the impact of these methods on CKD staging, and to evaluate the applicability of the enzymatic method as a reflective test.
Materials and Methods: A total of 176 CKD patients were prospectively analyzed. Serum creatinine levels were measured using both Jaffe and enzymatic methods, and eGFR was calculated using the 2021 CKD-EPI formula. Correlation between methods was assessed using Spearman’s test, differences via Bland–Altman analysis, and staging agreement using Cohen’s Kappa.
Results: A significant positive correlation was found between the two methods (Spearman’s rho = 0.986; p < 0.001). It was observed that eGFR values calculated using the Jaffe method led to misclassification in 39.4% of cases, particularly in stage G3a. Stage mismatch was detected in 27.3%, 20%, and 27.8% of cases in stages G3b, G4, and G5, respectively. Overall, 23.26% of patients were assigned to different stages.
Conclusions: The creatinine measurement method is not only analytical but also a critical factor that directly influences clinical decisions. In particular, different staging using the Jaffe method is common in patients with moderate CKD (G2–G3a). The application of the enzymatic method as a reflective test may be effective in preventing these deviations. Therefore, it is recommended that reflective test algorithms be integrated into laboratory workflows and that the creatinine measurement method used be reflected in the eGFR interpretation.

Anahtar Kelimeler

Chronic Kidney Disease, Enzymatic Method, ; Estimated Glomerular Filtration Rate (eGFR), Jaffe Method, Reflective Testing

Destekleyen Kurum

not

Etik Beyan

The study was approved by the Clinical Research Ethics Committee of University of Health Sciences, Istanbul Education and Research Hospital (Approval No: 1448, Date: 28.09.2018).

Teşekkür

We would like to thank Prof. Dr. Macit Koldaş for his contributions.

Kaynakça

  1. 1. Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, et al. Global prevalence of chronic kidney disease: a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765.
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  8. 8. Ávila M, Mora Sánchez MG, Bernal Amador AS, Paniagua R. The metabolism of creatinine and its usefulness to evaluate kidney function and body composition in clinical practice. Biomolecules. 2025;15(1):41.
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Kaynak Göster

APA
Yıldız, A., & Yücetaş, E. (2026). An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages. Genel Tıp Dergisi, 36(2026), 1-7. https://doi.org/10.54005/geneltip.1779315
AMA
1.Yıldız A, Yücetaş E. An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages. Genel Tıp Derg. 2026;36(2026):1-7. doi:10.54005/geneltip.1779315
Chicago
Yıldız, Ayla, ve Esma Yücetaş. 2026. “An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages”. Genel Tıp Dergisi 36 (2026): 1-7. https://doi.org/10.54005/geneltip.1779315.
EndNote
Yıldız A, Yücetaş E (01 Temmuz 2026) An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages. Genel Tıp Dergisi 36 2026 1–7.
IEEE
[1]A. Yıldız ve E. Yücetaş, “An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages”, Genel Tıp Derg, c. 36, sy 2026, ss. 1–7, Tem. 2026, doi: 10.54005/geneltip.1779315.
ISNAD
Yıldız, Ayla - Yücetaş, Esma. “An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages”. Genel Tıp Dergisi 36/2026 (01 Temmuz 2026): 1-7. https://doi.org/10.54005/geneltip.1779315.
JAMA
1.Yıldız A, Yücetaş E. An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages. Genel Tıp Derg. 2026;36:1–7.
MLA
Yıldız, Ayla, ve Esma Yücetaş. “An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages”. Genel Tıp Dergisi, c. 36, sy 2026, Temmuz 2026, ss. 1-7, doi:10.54005/geneltip.1779315.
Vancouver
1.Ayla Yıldız, Esma Yücetaş. An Example for Reflective Testing: Enzymatic Creatinine Determination Method in Patients with Chronic Renal Failure at Different Stages. Genel Tıp Derg. 01 Temmuz 2026;36(2026):1-7. doi:10.54005/geneltip.1779315