POCT Creatinine vs main lab Creatinine discrepancy

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We had an issue with a patient giving a Stat Sensor creatinine of 1.70 and a main lab plasma creatinine of 3.0. Everyone is going crazy about the discrepancy. This is whole blood vs plasma, POCT Stat Sensor vs Abbott's Architect. All our correlation has been whole blood vs whole blood. Prime Plus vs Stat Sensor.  How would you resolve this? The results are confusing people. Thanks!

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We had an issue similar to this a few years ago on results that didn't match from the i-STAT to Chemistry's Siemens Vista. It turns out the discrepancy was likely caused by and overestimation of the Creat by the chemistry analyzer. If the Architect uses the Jaffe method, it is affected by elevated glucose. In our case, the i-STAT which uses a direct method was lower, but more accurate.  If this was the case for you, please see the attached article: Clinical and Analytical Impact of Moving from Jaffe to Enzymatic Serum Creatinine Methodology | The Journal of Applied Laboratory Medicine | Oxford Academic (oup.com)

Thank you, Kelsey.  Appreciate you sending the article.

I've also seen this in patient's that had just recieved a chemotherapy bolus the day before.  The drug was listed as an interferant for the iSTAT.

We had this happen in our DI with a StatSensor as well. Nova opened an investigation but no resolution was obtained (I was hoping an interfering substance would have been identified). 
We use a positive y offset to more closely match our Beckman AU assay results. Do you use an offset at all?

Appreciate the responses. Thanks

Do you run your POC creatinine from a heparinized whole blood tube or straight whole blood? We see discrepancies if partially-filled heparinized tube. 

We do whole blood.
We are looking to add a disclaimer to the result, regarding the different methods and different matrix, if they see a discrepancy.

Thanks!

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Vivian Morales
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