GLOMERULAR-FILTRATION RATE AND CREATININE PRODUCTION IN ADULT ICTERICPATIENTS

Various methods for serum creatinine determination were compared and v alidity of the Cockroft-Gault algorithm for calculating creatinine cle arance was tested in adult icteric patients, Using conventional Jaffe assays, negative interference is proportional to the serum bilirubin c ontent. Pretreatment of the serum with bilirubin oxidase was more effi cient in eliminating bilirubin than pretreatment with potassium ferric yanide. Due to a continued creatine-poor diet and liver dysfunction, e rythrocyte creatine levels and creatinine output rate were decreased. Median effect (creatinine equivalent) of non-specific chromogens in th e unmodified Jaffe assay was 21 mumol/l (range: 1-108 mumol/l), vs. 19 mumol/l (range: 16-26 mumol/l) for the reference population. In the a bsence of multi-organ failure, the Cockroft-Gault algorithm could be u sed for estimating glomerular filtration rate. In patients with multip le organ failure however, we recommend correction for both bilirubin a nd non-specific chromogens for measuring the serum creatinine concentr ation.