Serum creatinine. From clinical practice to epidemiology through determination standards and quality control across clinical laboratories

• Main Authors: Ana María Cusumano, Gustavo A. Velasco, María Eugenia Bianchi, Candela Torres, Romina Ceci, Daniel Mazziotta, Felipe Inserra
• Format: Article
• Language: Spanish
• Published: Asociación Regional de Diálisis y Trasplantes Renales de Capital Federal y Provincia de Buenos Aires 2016-09-01
• Series: Revista de Nefrología, Diálisis y Trasplante
• Subjects: tasa de filtración glomerular; estandarización de creatinina
• Online Access: http://www.revistarenal.org.ar/index.php/rndt/article/view/76

This article attempts to show why it is necessary to improve quality control of clinical laboratories and move toward standardization of serum creatinine to help improve clinical and epidemiological diagnosis of chronic kidney disease especially in Latin America. The role of clinical laboratory is to provide useful, reliable and reproducible information to be used in clinical practice, regardless of the methodology used and the intervening laboratory. For this, quality was implemented to improve the systematic and random errors in the determinations of clinical laboratories. Standardization programs are launched in 2006. Moreover serum creatinine and creatinine clearance joined the clinic, to be arrived at a milestone that was the determination of the estimated Glomerular Filtration Rate (eGFR) from formulas (MDRD and CKD-EPI). The need for standardization of the determination of creatinine was established in the Guide 4 KDOQUI in 2002. Regarding the determination of serum creatinine for estimating eGFR, a long way has come: from identification of the concept of clearance, its application to the determination of renal function, its use in the clinic for diagnosis, progression and prognosis, identifying it as an epidemiological indicator in population risk setting. In this context the need for standardization is established.