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Technical Briefs |
1
Department of Clinical Biochemistry, East Kent Hospitals NHS Trust, Kent and Canterbury Hospital, Ethelbert Road, Canterbury CT1 3NG, Kent, United Kingdom
2
The South West Thames Institute for Renal Research, St. Heliers Hospital, Carshalton SM5 1AA, Surrey, United Kingdom
aauthor for correspondence: fax 44-1227-783077, e-mail edmund.lamb@kch-tr.sthames.nhs.uk
The serum cystatin C concentration reflects glomerular filtration and, as a marker of renal disease, demonstrates improved accuracy and sensitivity compared with serum creatinine (1)(2)(3). Several assays (4) have been described for cystatin C, including latex particle-enhanced nephelometric immunoassays (PENIAs) (5) and turbidimetric immunoassays (PETIAs) (2)(3). The PETIA marketed by Dako Ltd (cat. no. K 0071; Ely, United Kingdom) has been adapted to a variety of automated analyzers that use fixed-interval turbidimetric measurement (6)(7). However, the analytical performance initially described for this method (2) has not always been replicated. Compared with the PENIA developed for the Dade Behring (Milton Keynes, United Kingdom) nephelometers [e.g., the Behring Nephelometer II (BNII)], the PETIA demonstrates high imprecision at the upper limit of the reference interval (6)(8)(9) and susceptibility to spectral interferences (4). On a Cobas Mira S Plus analyzer, these reagents were subject to interference from bilirubin (>270 µmol/L), hemoglobin (>4 g/L), and triglycerides (>5.7 mmol/L), and between-day imprecision (CV) exceeded 8% at 1.10 and 4.10 mg/L (10).
We describe the measurement of cystatin C using an adaptation of these reagents in a nephelometric immunoassay using kinetic rate analysis. All analyses were performed with a single batch of reagent on an automated rate nephelometer (ImmageTM analyzer; Beckman-Coulter Ltd., High Wycombe, United Kingdom). Recombinant human cystatin C calibrators supplied by the manufacturer were used, and an additional calibrator was prepared by diluting (1:1) the calibrator with the lowest cystatin C concentration (0.39 mg/L) in phosphate buffer, pH 7.0 (cat. no. 447640; Beckman-Coulter Ltd.). The calibrator with the highest concentration (12.3 mg/L) was not used. Analyses were performed in user-defined mode, using provisional settings provided
Acknowledgments
References
The following articles in journals at HighWire Press have cited this article:
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E. J. Lamb, H. J. Stowe, D. E. Simpson, A. J. Coakley, D. J. Newman, and M. Leahy Diagnostic Accuracy of Cystatin C as a Marker of Kidney Disease in Patients with Multiple Myeloma: Calculated Glomerular Filtration Rate Formulas Are Equally Useful Clin. Chem., October 1, 2004; 50(10): 1848 - 1851. [Full Text] [PDF] |
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