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Abstract: FR-PO1048

Determining Protein-to-Creatinine Ratio in Patients Receiving SGLT2 Inhibitors: Does Urinary Glucose Interfere with Jaffe Reaction?

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Oguntuwase, Elizabeth Feyikemi, Weill Cornell Medicine, New York, New York, United States
  • Maniccia, Samantha, Weill Cornell Medicine, New York, New York, United States
  • Rai, Alex J., Columbia University, New York, New York, United States
  • Yang, He S, Weill Cornell Medicine, New York, New York, United States
  • Muthukumar, Thangamani, Weill Cornell Medicine, New York, New York, United States
Background

Glycosuria due to SGLT2 inhibitors (SGLT2i) use may interfere with urinary creatinine measurement by the Jaffe method. Creatinine is commonly measured using Jaffe's colorimetric method. Overestimation of urine creatinine could alter the urine protein: creatinine ratio, resulting in the overestimation of the benefit of SGLT2i in proteinuria reduction.

Methods

We studied 69 adult kidney transplant recipients: 33 on SGLT2i (experimental group, 19 on dapagliflozin, and 14 on empagliflozin), and 36 not on SGLT2i (control group). Urine specimens obtained during their routine clinic visit on a given day were split into two aliquots. Urine creatinine was measured using the Jaffe colorimetric assay (Siemens ADVIA XPT Chemistry System) and the enzymatic creatinine assay (Roche c501 module). We used Deming regression and Bland-Altman plots to compare the two methods.

Results

The median (IQR) urine glucose concentration in the experimental group was 1544 mg/dl (663-2512). The median (IQR) urine creatinine in the experimental group was 74.90 mg/dl (42.65-96.35) by the Jaffe method and 78.30 mg/dl (43.45-96.95) by the enzymatic method. In the control group, the urine creatinine was 100.2 mg/dl (61.94-148.40) and 98.60 mg/dl (62.15-148.50), respectively.

Deming regression analysis revealed a proportional bias of less than 5% in both groups (Figure 1). By Bland Altman analysis, the bias in urine creatinine measurement was -1.3 mg/dl in the experimental group (95% LOA: -7.9 to 5.30) and -1.6 mg/dl (95% LOA: -7.5 to 4.3) in the control group (Figure 2).

Conclusion

Urine creatinine measurement by Jaffe's colorimetric method is not influenced by glycosuria due to the use of SGLT2i.

Digital Object Identifier (DOI)