Limitations of compensated Jaffe creatinine assays in cirrhotic patients

ObjectivesThis study aimed to evaluate the impact of two creatinine measurement methods on the Model for End Stage Liver Disease (MELD) score and glomerular filtration rate estimation (eGFR) in cirrhotic patients. We focused on ID-MS traceable method such as compensated Jaffe (cJafCreat) and enzymatic (EnzCreat) methods.Design and methodsPotential protein-related interferences in creatinine determination were evaluated using dialysates spiked with albumin. MELD score, CKD-EPI formula creatinine-based eGFR and cystatin C-based eGFR were evaluated in 100 cirrhotic patients.ResultsIn vitro model demonstrated that low protein levels result in an underestimation of creatinine levels using cJafCreat. In patients, cJafCreat created a negative bias of − 6.1 μmol/L that led to higher eGFR and lower MELD scores.ConclusionscJafCreat contributes to an overestimation of renal function in cirrhotic patients and may alter cirrhosis-severity assessment. Compensated Jaffe assays should therefore be replaced by enzymatic methods.

► We compared compensated Jaffe and enzymatic creatinine assays in cirrhotic patients. ► Compensated Jaffe assay led to lower creatinine measurements. ► Compensated Jaffe assay led to lower MELD scores. ► Compensated Jaffe assay led to higher estimated glomerular filtration rates. ► Renal function in cirrhotic patients should be evaluated using enzymatic assays.