Poor comparability of plasma renin activity measurement in determining patient samples: the status quo and recommendations for harmonization
Author:
Liu Zhenni12ORCID, Jin Lizi12ORCID, Zeng Jie1, Zhang Tianjiao12, Zhang Jiangtao1, Zhou Weiyan1, Zhang Chuanbao12
Affiliation:
1. National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences , Beijing Hospital/National Center of Gerontology , Beijing , P.R. China 2. Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , P.R. China
Abstract
Abstract
Objectives
This study aims to investigate and update the consistency and comparability of plasma renin activity (PRA) assays in measuring clinical samples. The contributions of recalibration, blank subtraction, and incubation strategies to interchangeability were also explored.
Methods
Five different laboratories were evaluated using forty-six individual plasma samples, including four liquid chromatography-tandem mass spectrometry (LC‒MS/MS) assays and one chemiluminescence immunoassay (CLIA). Spearman correlation coefficient (R), Passing–Bablok regression, and Bland‒Altman plot analyses were used to evaluate the consistency among assays. Consistency before and after recalibration, blank subtraction, and incubation strategy unification was compared.
Results
A good correlation was observed among all assays (R>0.93). None of the samples measured by all assays showed coefficient variation (CV) <10 %, and 37 % of samples showed overall CVs >20 %. The 95 % confidence intervals (CIs) for slopes did not contain 1 for most assay pairs. Large relative biases (−85.1–104.2 %) were found, and 76 % (52–93 %) of samples had unacceptable biases. Recalibration reduced the calibration bias. Ignoring blank subtraction improved the comparability across all assays while unifying incubation did not.
Conclusions
The interchangeability of PRA measurement was unsatisfying. Harmonization on calibrator and ignoring blank were recommended. Unifying incubation strategy was unnecessary.
Funder
Beijing Natural Science Foundation National Key Research and Development Program of China
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,General Medicine
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