BACKGROUND: Assessment 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. METHODS: Real-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. RESULTS: In 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. CONCLUSION: In a polymedicated urgent care hospital population, a creatinine enzyme method produces unreliable results, apparently due to multiple drug-related interferences.

Department of Laboratory Medicine University Hospital Brno Brno Czechia

Department of Laboratory Medicine University Hospital Brno Masaryk University Brno Czechia

Department of Laboratory Methods Faculty of Medicine Masaryk University Brno Czechia

Department of Mathematics and Statistics Faculty of Science Masaryk University Brno Czechia

Department of Pediatric Hematology and Biochemistry University Hospital Brno Brno Czechia

Department of Pediatric Oncology University Hospital Brno Brno Czechia

Department of Pediatrics Pediatric Nephrology Unit University Hospital Brno Brno Czechia

Department of Pharmacology and Toxicology Faculty of Pharmacy Masaryk University Brno Czechia

Department of Pharmacology Faculty of Medicine Masaryk University Brno Czechia

Department of Pharmacy Clinical Pharmacy Services Unit University Hospital Brno Brno Czechia

Department of Pharmacy University Hospital Brno Brno Czechia

Diagnostic and Therapeutic Centre Emergency Services Department University Hospital Brno Masaryk University Brno Czechia

Faculty of Medicine Masaryk University Brno Czechia

General Teaching Hospital Prague Czechia

Research Unit for Rare Diseases Department of Pediatrics and Inherited Metabolic Disorders 1st Faculty of Medicine Charles University Prague Czechia

Spadia Laboratories Central Reference Lab Division of Clinical Biochemistry Ostrava Czechia

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$a Emergency medicine pharmacotherapy compromises accuracy of plasma creatinine determination by enzyme-based methods: real-world clinical evidence and implications for clinical practice / $c R. Demlova, S. Kozakova, M. Rihacek, D. Buckova, K. Horska, O. Wiewiorka, L. Boucek, I. Selingerova, M. Podborska, A. Korberova, A. Mikuskova, J. Starha, M. Benovska, M. Radina, M. Richter, L. Zdrazilova Dubska, D. Valik

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$a BACKGROUND: Assessment 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. METHODS: Real-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. RESULTS: In 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. CONCLUSION: In a polymedicated urgent care hospital population, a creatinine enzyme method produces unreliable results, apparently due to multiple drug-related interferences.

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$a Horska, Katerina $u Department of Pharmacy, Clinical Pharmacy Services Unit, University Hospital Brno, Brno, Czechia $u Department of Pharmacology and Toxicology, Faculty of Pharmacy, Masaryk University, Brno, Czechia

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$a Wiewiorka, Ondrej $u Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia $u Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia

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$a Selingerova, Iveta $u Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia $u Department of Mathematics and Statistics, Faculty of Science, Masaryk University, Brno, Czechia

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$a Podborska, Martina $u Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia $u Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia

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$a Valik, Dalibor $u Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia $u Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia $u Department of Laboratory Medicine, University Hospital Brno, Brno, Czechia $u Department of Pediatric Oncology, University Hospital Brno, Brno, Czechia

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