Evaluation of stability of urea and creatinine in dried blood spot stored at different temperature

Authors

  • Vikram Shrestha Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, Nepal
  • Neetu Amatya Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, Nepal
  • Anjila Shrestha Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, Nepal
  • Bhuvan Saud Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, Nepal
  • Govinda Paudel Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, Nepal

Keywords:

DBS, urea, creatinine, stability

Abstract

Background: The wide applications and merits of Dried Blood Spot (DBS) sampling has a high significance of early diagnosis and treatment of renal diseases in the context of Nepal where incidence of high mortality and morbidity rate is seen due to lack of proper diagnostic system and medical resources. Urea and creatinine are the easiest parameters to assess renal function test via DBS sampling.

Method: An experimental based, convenient sampling technique was performed during the health camp at Janamaitri Hospital, Kathmandu, Nepal from May 2018 to October 2018. A total of 25 participants were enrolled and blood samples were collected then DBS preparation was done. The serum sample on the day of collection was estimated for Urea and Creatinine concentration whilst DBS were stored under room temperature, 37ºC and 4ºC and examined for both analytes on Day 15, 30 and 45 respectively.

Results: Out of total 25 samples, the mean (± standard deviation) value of urea and creatinine of serum on the day of collection were 25.36 (± 2.90) and 1.03(± 0.16) respectively. The stability was reported to be good at 4ºC for both analytes where p-value was non-significant (≥0.05) reflecting its stability whereas under 37ºC, DBS stability in all days declined for Urea with a significant association i.e. p < 0.05 reflecting its instability. Mean creatinine values were stable comparatively to that of urea under all temperature and test days. As the storage temperature increases, the decline in concentration of analytes was noted.

Conclusion: This study demonstrated that DBS technique can be used to assess renal function tests and stability of creatinine is suitable under all temperature for longer storage. Optimal temperature for storage to be 4ºC.

References

What is Dried Blood Spot Testing? - Chromatography Explores [Internet]. Chromatograhy Today, 2019. [cited 2022 Apr 5]. Available from: https://www.chromatographytoday.com/news/hplc-uhplc/31/breaking-news/what-is-dried-blood-spot-testing-chromatography-explores/48468.

Grüner N, Stambouli O, Ross RS. Dried blood spots--preparing and processing for use in immunoassays and in molecular techniques. J Vis Exp. [Internet], 2015; 97:52619. doi: 10.3791/52619. PMID: 25867233; PMCID: PMC4397000.

Abraham RA, Kapil U, Aggarwal SK, Pandey RM, Sharma M, Ramakrishnan L. Measurement of Creatinine from Dried Blood spot by Enzymatic Method. Int J Adv Res Chem Sci, 2015; 2(12):42-6.

Saud B. Dried Blood Spot for Developing Countries: An | Opinion. Curr Trends Biomed Eng Biosci, 2018; 14(3):2-4.

Centers for Disease Control and Prevention. Shipping Guidelines for Dried-Blood Spot Specimens [Internet], 2017, 1-4. [cited 2022 Apr 5] Available from: https://www.cdc.gov/labstandards/pdf/nsqap/Bloodspot_Transportation_Guidelines.pdf.

Lim MD. Review article: Dried blood spots for global health diagnostics and surveillance: Opportunities and challenges. Am J Trop Med Hyg, 2018; 99(2):256-65. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090344/pdf/tpmd170889.pdf.

Ostler MW, Porter JH, Buxton OM. Dried blood spot collection of health biomarkers to maximize participation in population studies. J Vis Exp, 2014; 83:1-9.

Trifonova OP, Maslov DL, Balashova EE, Lokhov PG. Evaluation of dried blood spot sampling for clinical metabolomics: Effects of different papers and sample storage stability. Metabolites, 2019, 9(11).

Malsagova K, Kopylov A, Stepanov A, Butkova T, Izotov A, Kaysheva A. Dried blood spot in laboratory: Directions and prospects. Diagnostics, 2020, 10(4).

Thapa B, Koirala S, Upadhaya BP, Mahat K, Malla S, et al. National External Quality Assurance Scheme for HIV Testing using Dried Blood Spot: A Feasibility Study. Saarc J Tuber Lung Dis Hiv/Aids, 2011; 8(2):23-7.

Zakaria R, Allen KJ, Koplin JJ, Roche P, Greaves RF. Recent Developments in the Clinical Application of Mass Spectrometry: Advantages and challenges of dried blood spot analysis by mass spectrometry across the total testing process. EJIFCC. 2016; 27(4):288-317.

Higgins C. Urea and creatinine concentration, the urea:creatinine ratio. Acute Care Test [Internet], 2016, 1-8. [Accessed date: 2022 Apr 5] Available from: www.acutecaretesting.org.

Quraishi R, Lakshmy R, Mukhopadhyay AK, Jailkhani BL. Analysis of the stability of urea in dried blood spots collected and stored on filter paper. Ann Lab Med, 2013; 33(3):190-192. doi:10.3343/alm.2013.33.3.190.

Abraham RA, Kapil U, Aggarwal SK, Pandey RM, Sharma MRL. Measurement of Creatinine from Dried Blood spot by Enzymatic Method. Int J Adv Res Chem Sci, 2015; 2(12):42-6.

WHO. WORLD HEALTH RANKINGS. NEPAL: KIDNEY DISEASE [Internet], 2018. [Accessed Date:2022 Apr 5] Available from:https://www.worldlifeexpectancy.com/nepal-kidney-disease.

Poudyal A, Karki KB, Shrestha N, Aryal KK, Mahato NK, Bista B, et al. Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study. BMJ Open. 2022; 12(3):e057509.

Whittaker K, Mao YQ, Lin Y, Zhang H, Zhu S, Peck H, et al. Dried blood sample analysis by antibody array across the total testing process. Sci Rep [Internet], 2021; 11(1):1–13.

Mula-Abed WAS, Al Rasadi K, Al-Riyami D. Estimated glomerular filtration rate (eGFR): A serum creatinine-based test for the detection of chronic kidney disease and its impact on clinical practice. Oman Med J, 2012; 27(2):108-13.

Panyachariwat N SH. Stability of urea in solution and pharmaceutical preparations. J Cosmet Sci, 2014; 65(3):187-95.

Koster RA, Greijdanus B, Alffenaar JWC, Touw DJ. Dried blood spot analysis of creatinine with LC-MS/MS in addition to immunosuppressants analysis. Anal Bioanal Chem, 2014; 407(6):1585-94.

Küme T, Sağlam B, Ergon C, Sisman AR. Evaluation and comparison of Abbott Jaffe and enzymatic creatinine methods: Could the old method meet the new requirements? J Clin Lab Anal, 2018; 32(1):1-8.

Downloads

Published

2021-04-25

How to Cite

[1]
V. Shrestha, N. Amatya, A. Shrestha, B. Saud, and G. . Paudel, “Evaluation of stability of urea and creatinine in dried blood spot stored at different temperature”, J. A. Med. Sci, vol. 1, no. 1, pp. 07–11, Apr. 2021.

Issue

Section

Articles