Albumin determined by bromocresol green leads to erroneous results in routine evaluation of patients with chronic kidney disease.

Autor:	van Schrojenstein Lantman M; Result Laboratorium, Amphia, Breda, The Netherlands.; SKML, Nijmegen, The Netherlands.; Division of Laboratory Medicine, Radboudumc, Nijmegen, The Netherlands., van de Logt AE; Division of Nephrology, Radboudumc, Nijmegen, The Netherlands., Prudon-Rosmulder E; Division of Laboratory Medicine, Radboudumc, Nijmegen, The Netherlands., Langelaan M; Result Laboratorium, Amphia, Breda, The Netherlands., Demir AY; Laboratory for Clinical Chemistry and Hematology, Meander Medical Center, Amersfoort, The Netherlands., Kurstjens S; Laboratory of Clinical Chemistry and Hematology, Jeroen Bosch Hospital, Den Bosch, The Netherlands., van der Horst A; Laboratory of Clinical Chemistry and Hematology, Jeroen Bosch Hospital, Den Bosch, The Netherlands., Kuypers A; Laboratory Maasziekenhuis Pantein, Beugen, The Netherlands., Greuter A; Laboratory for Clinical Chemistry and Hematology, Tergooi Ziekenhuis, Hilversum, The Netherlands., Kootstra-Ros J; Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands., van der Hagen E; MCA Laboratory, Queen Beatrix Hospital, Winterswijk, The Netherlands., Oostendorp M; Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, The Netherlands., de Beer R; Laboratory for Medical Diagnostics, Rivierenland Hospital, Tiel, The Netherlands., Ramakers C; Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands., Bakkeren D; Máxima Medical Center (MMC), Department of Clinical Chemistry, Veldhoven, The Netherlands., Lindeboom F; Department of Clinical Chemistry and Haematology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands., van de Wijngaart D; Accureon BV, Department of Clinical Chemistry, Bravis Hospital, Bergen op Zoom, The Netherlands.; Zorgsaam Hospital, Terneuzen, The Netherlands., Thelen M; SKML, Nijmegen, The Netherlands.; Division of Laboratory Medicine, Radboudumc, Nijmegen, The Netherlands., Wetzels J; Division of Nephrology, Radboudumc, Nijmegen, The Netherlands., van Berkel M; Division of Laboratory Medicine, Radboudumc, Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Clinical chemistry and laboratory medicine [Clin Chem Lab Med] 2023 Jul 04; Vol. 61 (12), pp. 2167-2177. Date of Electronic Publication: 2023 Jul 04 (Print Publication: 2023).
DOI:	10.1515/cclm-2023-0463
Abstrakt:	Objectives: Measurement of plasma albumin is pivotal for clinical decision-making in patients with chronic kidney disease (CKD). Routinely used methods as bromocresol green (BCG) and bromocresol purple (BCP) can suffer from aselectivity, but the impact of aselectivity on the accuracy of plasma albumin results of CKD-patients is still unknown. Therefore, we evaluated the performance of BCG-, BCP- and JCTLM-endorsed immunological methods in patients with various stages of CKD. Methods: We evaluated the performance of commonly used albumin methods in patients with CKD stages G1 through G5, the latter divided in two groups based on whether they received hemodialysis treatment. In total, 163 patient plasma samples were measured at 14 laboratories, on six different BCG and BCP-platforms, and four different immunological platforms. The results were compared with an ERM-DA-470k-corrected nephelometric assay. The implications on outcome is evaluated by the proportion of patient results <38 g/L for the diagnosis of protein energy wasting. Results: Albumin results determined with BCP- and immunological methods showed the best agreement with the target value (92.7 and 86.2 %, respectively vs. 66.7 % for BCG, namely due to overestimation). The relative agreement of each method with the target value was platform-dependent, with larger variability in agreement between platforms noted for BCG and immunological methods (3.2-4.6 and 2.6-5.3 %) as opposed to BCP (0.7-1.5 %). The stage of CKD had similar effects on the variability in agreement for the three method-groups (0.6-1.8 % vs. 0.7-1.5 % vs. 0.4-1.6 %). The differences between methods cause discrepancies in clinical decision-making, as structurally fewer patients were diagnosed with protein energy wasting upon using BCG-based albumin results. Conclusions: Our study shows that BCP is fit for the intended use to measure plasma albumin levels in CKD patients from all stages, including patients on hemodialysis. In contrast, most BCG-based platforms falsely overestimate the plasma albumin concentration. (© 2023 the author(s), published by De Gruyter, Berlin/Boston.)
Databáze:	MEDLINE
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