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  • 1 Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Klinikai Biokémiai és Molekuláris Patológiai Intézet Debrecen Nagyerdei krt. 98. Pf. 70. 4032
  • 2 Modulab Kft. FMC Diagnosztikai Laboratóriuma Miskolc
  • 3 Miskolci Egyetem Alapozó Egészségtudományi Tanszék Miskolc
  • 4 Szegedi Tudományegyetem, Általános Orvostudományi Kar Klinikai Kémiai Intézet Szeged
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A 2006. évi ajánlások szerint az alapellátásban is alkalmazni kell a szérumkreatininből képlettel számított glomerulus filtrációs rátát, amely segít a krónikus vesebetegség korai felismerésében. Emiatt előtérbe kerültek a Jaffe-féle kreatininmeghatározás korlátai, és az eredmények összevethetősége érdekében felmerült az igény a leggyakrabban használt Jaffe- és az újabb kreatininmeghatározások harmonizációjára. A kinetikus Jaffe-féle kreatininmeghatározás hátránya, hogy nem elég specifikus. Ezen javítottak az elmúlt évtizedben bevezetett enzimatikus, kompenzált Jaffe és nagyfelbontású folyadékkromatográfiás módszerek. Az újabb módszerekkel kapott kreatininértékek már pontosabbak, de alacsonyabb értékük miatt a korábbi formulákkal (4 változós Modification of Diet in Renal Disease-186, Cockcroft–Gault, kvadratikus) nem lehet belőlük glomerulus filtrációs rátát számítani, mert durván torzítanák azt. Az új kreatininmódszerek miatt a korábbi számítási mód, s így a krónikus vesebetegség stádiumának meghatározása is bizonytalanná vált. Emiatt 2006-ban módosították a 4-változós Modification of Diet in Renal Disease-186 formulát, és az új (izotópdilutiós tömegspektrometriás referenciamódszerre visszavezethető) kreatininhez csak az új 4 változós Modification of Diet in Renal Disease-175 képlet ajánlott. A szerzők összevetik a kreatininmódszerek diagnosztikai értékét és korlátait.

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