Clinical chemistry最新文献

eGFR Inaccuracy in the Assessment of Living Kidney Transplant Donor Eligibility. eGFR在活体肾移植供者资格评估中的不准确性。

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-08-01 DOI: 10.1093/clinchem/hvaf071

Sarrah Lahorewala, Zheng Yin, Jacob Kinskey, Shane A Bobart, Angelina Edwards, Paul Christensen, Roger L Bertholf, Xin Yi

{"title":"eGFR Inaccuracy in the Assessment of Living Kidney Transplant Donor Eligibility.","authors":"Sarrah Lahorewala, Zheng Yin, Jacob Kinskey, Shane A Bobart, Angelina Edwards, Paul Christensen, Roger L Bertholf, Xin Yi","doi":"10.1093/clinchem/hvaf071","DOIUrl":"10.1093/clinchem/hvaf071","url":null,"abstract":"Background: Accurate glomerular filtration rate (GFR) estimation is crucial for evaluating living kidney donors, especially when measured GFR (mGFR) is unavailable. This study compares the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), full age spectrum (FAS), and European Kidney Function Consortium (EKFC) creatinine- and/or cystatin C-based estimated GFR (eGFR) equations against iohexol mGFR to determine the optimal equation for donor eligibility assessment in a US population.Methods: 1210 kidney donor candidates were retrospectively analyzed, comparing eGFR equations based on creatinine, cystatin C, or both against iohexol mGFR. Accuracy metrics (P10, P30, mean bias) and subgroup analyses for Black donors and age-based bias were evaluated. The classification performance of eGFR equations in donor eligibility was examined.Results: The 2021 CKD-EPIcr [AS (age, sex)] demonstrated the best accuracy across the overall cohort (P10 48.2%, P30 93.2%, mean bias -4.8 mL/min/1.73 m²). The 2021 CKD-EPIcr-cys (AS) excelled in Black donors (P10 60.3%, P30 95.4%, mean bias -3.6 mL/min/1.73 m²). Cystatin C-based equations showed higher negative bias, with the largest underestimation observed in older donors. All equations demonstrated <35% positive predictive value (PPV) for rejecting ineligible donors (<60 mL/min/1.73 m²) but >85% PPV in determining acceptable donors (≥90 mL/min/1.73 m²). Overall, 2021 CKD-EPIcr-cys (AS) was the most reliable for identifying acceptable donors (F1 score 83.9 at ≥90 mL/min/1.73 m²). Using age/sex-specific thresholds improved performance of all equations in donor eligibility classification compared to absolute thresholds.Conclusions: No eGFR equation reliably rejected ineligible donors. 2021 CKD-EPIcr-cys (AS) exhibited the best overall performance for donor eligibility assessment.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":" ","pages":"870-883"},"PeriodicalIF":6.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Ambiguous NUDT15 Signal in a Child with B-cell Acute Lymphoblastic Leukemia. 一个模糊的NUDT15信号在儿童b细胞急性淋巴细胞白血病。

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-01 DOI: 10.1093/clinchem/hvaf028

Rosalie M Sterner,Farha Sherani,Margaret A DiGuardo,Patricia T Greipp,Ann M Moyer

引用次数: 0

Toward Improved Prostate Cancer Screening: Insights from the Göteborg-2 Trial. 改善前列腺癌筛查：Göteborg-2试验的启示

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-08-01 DOI: 10.1093/clinchem/hvaf032

Jacob E Tallman, Sigrid V Carlsson, Hans Lilja

引用次数: 0

Discordance between Cystatin C-Based and Creatinine-Based Estimated Glomerular Filtration Rate as a Measure of Health. 基于胱抑素c和基于肌酐的肾小球滤过率作为健康指标之间的不一致。

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-01 DOI: 10.1093/clinchem/hvaf079

Sharanya Ramesh,Lesley A Inker

引用次数: 0

Correction to: Challenges in Hb A1c Point-of-Care Testing: Only 5 of 19 Hb A1c Point-of-Care Devices Meet IFCC and NGSP Certification Criteria on Independent Evaluation. 血红蛋白糖化血红蛋白即时检测的挑战：19个血红蛋白糖化血红蛋白即时检测设备中只有5个符合IFCC和NGSP独立评估认证标准。

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-08-01 DOI: 10.1093/clinchem/hvaf075

引用次数: 0

Commentary on An Ambiguous NUDT15 Signal in a Child with B-Cell Acute Lymphoblastic Leukemia. 儿童b细胞急性淋巴细胞白血病中一个不明确的NUDT15信号。

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-01 DOI: 10.1093/clinchem/hvaf042

Wanxia Gai

引用次数: 0

Commentary on An Ambiguous NUDT15 Signal in a Child with B-Cell Acute Lymphoblastic Leukemia. 儿童b细胞急性淋巴细胞白血病中一个不明确的NUDT15信号。

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-01 DOI: 10.1093/clinchem/hvaf069

Reynold C Ly

引用次数: 0

From Laptop to Laboratory: Development and Implementation of a Machine Learning Model for Detecting Iron-Deficiency Anemia. 从笔记本电脑到实验室：用于检测缺铁性贫血的机器学习模型的开发和实现。

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-07-29 DOI: 10.1093/clinchem/hvaf083

Nicholas C Spies

引用次数: 0

Assessment of Placental Chromosomal Mosaicism during Prenatal Cell-Free DNA Screening Refines Positive Predictive Values for Fetal Trisomy 产前无细胞DNA筛查中胎盘染色体嵌合体的评估提高了胎儿三体的阳性预测值

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-07-28 DOI: 10.1093/clinchem/hvaf076

Nicola J Flowers, Clare J Love, Katrina L Scarff, Olivia Giouzeppos, Alison D Archibald, Martin B Delatycki, Mark D Pertile

{"title":"Assessment of Placental Chromosomal Mosaicism during Prenatal Cell-Free DNA Screening Refines Positive Predictive Values for Fetal Trisomy","authors":"Nicola J Flowers, Clare J Love, Katrina L Scarff, Olivia Giouzeppos, Alison D Archibald, Martin B Delatycki, Mark D Pertile","doi":"10.1093/clinchem/hvaf076","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf076","url":null,"abstract":"Background Confined placental mosaicism can cause false-positive prenatal cell-free DNA (cfDNA) screening results, thereby reducing the positive predictive value (PPV) of the test. We sought to investigate how PPVs for the common fetal trisomies can be refined based on the presence or absence of chromosomal mosaicism in cfDNA sequencing data. Methods The study cohort included singleton pregnancies tested between March 2019 and December 2021. Outcome data were requested for high-risk results. Mosaic ratio (MR) generated by VeriSeq NIPT Solution v2 was used to classify high-risk cfDNA results as mosaic trisomy (MR &lt; 0.7) or non-mosaic trisomy (MR ≥ 0.7) and the PPVs calculated. Results The cohort consisted of 821 high-risk results from 76 329 tests (1.08%). Prior to applying MR, PPVs for T21, T18 and T13 were 93.3% [95% CI 90.2–95.5], 81% [95% CI 73.1–87.0], and 55.3% [95% CI 44.7–65.4], respectively. After applying MR, PPVs for non-mosaic trisomy results were significantly higher (P &lt; 0.001) than the PPVs for mosaic trisomy results; T21: 99.3% and 50%, T18: 97.6% and 22.7%, T13: 93.9% and 0%, respectively. Conclusions Mosaic ratio can be used to calculate more specific PPVs for the common trisomies. There is currently limited guidance on the application of VeriSeq v2 MR. Our approach provides a framework for laboratories to consider using MRs to refine PPV estimates for the common trisomies. High-risk cfDNA screening results are distressing for tested individuals. A refined PPV incorporating the presence or absence of mosaicism provides patients with more accurate information on the likely outcome of the diagnostic testing result, helping guide genetic counseling, choice of prenatal procedure, and overall pregnancy management.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"710 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous Glucose Monitors Have Acceptable Accuracy but High Discordance at High and Low Glucose Concentrations in Pediatric Hospitalized Patients. 在儿科住院患者中，连续血糖监测仪具有可接受的准确性，但在高血糖和低血糖浓度时存在高不一致性。

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-07-25 DOI: 10.1093/clinchem/hvaf080

Isaiah K Mensah,Vahid Azimi,Christopher W Farnsworth

{"title":"Continuous Glucose Monitors Have Acceptable Accuracy but High Discordance at High and Low Glucose Concentrations in Pediatric Hospitalized Patients.","authors":"Isaiah K Mensah,Vahid Azimi,Christopher W Farnsworth","doi":"10.1093/clinchem/hvaf080","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf080","url":null,"abstract":"BACKGROUNDContinuous glucose monitors (CGMs) assess interstitial glucose concentrations and improve diabetes management in outpatient settings. However, limited studies have assessed CGM performance in hospitalized pediatric patients, especially at high and low glucose thresholds near clinical decision limits.METHODSThis retrospective study included 72 hospitalized pediatric patients with dysglycemia who used CGMs during hospitalization. Paired CGM results within 10 min of laboratory (Lab) and point-of-care (POC) glucose results were retrieved. The mean absolute relative difference (MARD) and percentage of glucose values in acceptable Parkes error zones were assessed. Concordance of CGM and POC results and the frequency that CGM results <70 mg/dL and >180 mg/dL were confirmed (-15 min to +30 min) using POC was assessed.RESULTSThere were 2228 paired CGM and Lab or POC glucose results with a MARD of 14.8%, and 99.2% of results were in Parkes zones A and B. The MARD was 20.2% and 13.6% in the hypoglycemic and hyperglycemic ranges. The MARD for POC glucose meters was 15.6% and 8.2% for the hypoglycemic and hyperglycemic ranges. The Cohen kappa between CGM and POC was 0.66 (95% CI, 0.63-0.69). CGM results in the hypoglycemic and hyperglycemic ranges were repeated 80.2% and 16.5% of the time, respectively, with POC methods.CONCLUSIONThe MARD of CGM in hospitalized pediatric patients is clinically acceptable but there is high discordance between CGM and POC. This implies a clinical need to confirm high and low glucose concentrations with Lab or POC methods but confirmatory testing is commonly not performed.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"55 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0