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Avoiding falsely low creatinine concentrations measured in patients treated with N-acetylcysteine for acetaminophen intoxication using enzymo-amperometric method – An in vitro and in vivo study

Lefèvre, Charles R. ; Le Divenah, Felipe ; Collet, Nicolas ; Pelletier, Romain ; Robert, Eric ; Ropert, Martine ; Pawlowski, Maxime ; Gicquel, Thomas ; Bendavid, Claude

Clinica chimica acta, 2023-11, Vol.551, p.117611-117611, Article 117611 [Periódico revisado por pares]

Netherlands: Elsevier B.V

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  • Título:
    Avoiding falsely low creatinine concentrations measured in patients treated with N-acetylcysteine for acetaminophen intoxication using enzymo-amperometric method – An in vitro and in vivo study
  • Autor: Lefèvre, Charles R. ; Le Divenah, Felipe ; Collet, Nicolas ; Pelletier, Romain ; Robert, Eric ; Ropert, Martine ; Pawlowski, Maxime ; Gicquel, Thomas ; Bendavid, Claude
  • Assuntos: Acetaminophen ; Acetaminophen intoxication ; Acetylcysteine - therapeutic use ; Analytical interference ; Creatinine ; Creatinine assay ; Humans ; Life Sciences ; N-acetylcysteine ; Peroxidase ; Peroxidases ; Retrospective Studies
  • É parte de: Clinica chimica acta, 2023-11, Vol.551, p.117611-117611, Article 117611
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: •NAC interferes with Trinder-based creatinine assays in a concentration-dependent manner.•Enzymo-amperometric creatinine assays are unaffected.•Laboratory Medicine specialists must be aware of this interference and warn clinicians. Circulating creatinine is a biomarker of paramount importance in clinical practice. In cases of acetaminophen (APAP) intoxication, the antidote, N-acetylcysteine (NAC), interferes with commonly used creatininase-peroxidase methods. This study aimed to assess whether creatininase-amperometric methods were affected in this context. This study includes in vitro interference tests, involving four creatinine assays using NAC-spiked plasma pools and an in vivo retrospective study comparing creatininase-peroxidase and creatininase-amperometric measurements in patients presenting with NAC-treated APAP poisoning. Creatininase-peroxidase method was impacted by NAC interference in a clinically-significant manner at therapeutic NAC levels (basal value recovery of 80 % and 70 % for 500 and 1000 mg.L-1 of NAC, respectively), surpassing the desirable Reference Change Value (RCV%). Enzymo-amperometric methods were not impacted. Among patients, a mean bias of −45.2 ± 28.0 % was observed for the peroxidase detection method compared to the amperometric in those who received NAC prior plasma sampling and −2.7 ± 5.4 % in those who did not. Our findings indicate that enzymo-amperometric creatinine assays remain unaffected by NAC interference due to the absence of the peroxidase step in the analytical process. Therefore, these methods are suitable to prevent spurious hypocreatininemia in APAP intoxicated patients undergoing NAC therapy.
  • Editor: Netherlands: Elsevier B.V
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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