Tag Archives: glomerular filtration rate

Impact of creatinine measurement methods on eGFR and GFR category assignment

Elena-Cristina Preda, Oana Oprea, Zsolt Albert Barabas, Ioana Paula Simion, Ana-Maria Fotache, Minodora Dobreanu

George Emil Palade University of Medicine Pharmacy Science and Technology of Targu Mures, Romania

DOI: 10.2478/jccm-2026-0023

Background: Accurate measurement of serum creatinine (SCr) is critical in estimating glomerular filtration rate (eGFR) and classifying kidney function. This study evaluated the analytical differences between the enzymatic and Jaffe methods for SCr measurement and their impact on eGFR estimation using two widely applied equations: CKD-EPI and EKFC.
Methods: The study included 427 patients over 40 years old. SCr was measured using both enzymatic and Jaffe methods on the Alinity c platform. eGFR was calculated with the CKD-EPI (2009) and EKFC equations. Agreement between methods was assessed using Bland-Altman and Passing-Bablok regression. eGFR differences were analyzed using the Wilcoxon signed-rank test and multiple linear regression. Agreement in GFR category classification was evaluated using weighted kappa and Kendall’s tau.
Results: While the mean difference between methods was small, both systematic and proportional biases were statistically significant. eGFR values differed significantly between methods in both sexes (p < 0.01), regardless of the equation used. ΔeGFR was significantly associated with SCr values, but not with age. Although overall agreement in GFR categories was high (kappa > 0.91), method-dependent reclassification of patients was observed, which may influence CKD diagnosis and clinical decision-making.
Conclusions: Even minor analytical differences between enzymatic and Jaffe SCr measurements can lead to clinically relevant discrepancies in GFR categorization. These findings highlight the need for harmonization in laboratory methods to ensure consistent reporting and patient management.

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Neutrophil Gelatinase-Associated Lipocalin as a Marker for Renal Dysfunction Detection in Critically Ill Patients with Increased Intraabdominal Pressure

Claudiu Puiac1, Janos Szederjesi2, Alexandra Lazăr2, Codruța Bad2, Lucian Pușcașiu1

1 Gynecology and Obstetrics Department, University of Medicine and Pharmacy of Tirgu Mures, Romania
2 Anesthesiology Department, University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/jccm-2017-0006

Introduction: Elevated intraabdominal pressure (IAP) it is known to have an impact on renal function trough the pressure transmitted from the abdominal cavity to the vasculature responsible for the renal blood flow. Intraabdominal pressure is found to be frequent in intensive care patients and also to be a predictor of mortality. Intra- abdominal high pressure is an entity that can have serious impact on intensive care admitted patients, studies concluding that if this condition progresses to abdominal compartment syndrome mortality is as high as 80%.
Aim: The aim of this study was to observe if a link between increased intraabdominal pressure and modification in renal function exists (NGAL, creatinine clearance).
Material and Method: The study enrolled 30 critically ill patients admitted in the Intensive Care Unit of SCJU Tîrgu Mures between November 2015 and August 2016. The study enrolled adult, hemodynamically stable patients admitted in intensive critical care – defined by a normal blood pressure maintained without any vasopressor or inotropic support, invasive monitoring using PICCO device and abdominal pressure monitoring.
Results: The patients were divided into two groups based on the intraabdominal pressure values: normal intraabdominal pressure group= 52 values and increased intraabdominal group= 35 values. We compared the groups in the light of NGAL values, 24 hours diuresis, GFR and creatinine clearance. The groups are significantly different when compared in the light of NGAL values and GFR values. We obtained a statistically significant correlation between NGAL value and 24 hour diuresis. No other significant correlations were encountered between the studied items.
Conclusions: NGAL values are increased in patients with high intraabdominal pressure which may suggest its utility as a cut off marker for patients with increased intraabdominal pressure. There is a significant decreased GFR in patient with elevated intraabdominal pressure, observation which can help in early detection of renal injury in patients due to high intraabdominal pressure. No correlation was found between creatinine clearance and increased intraabdominal pressure.

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