Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

See all formats and pricing
More options …
Volume 44, Issue 12


Variations in assay protocol for the Dako cystatin C method may change patient results by 50% without changing the results for controls

Mats Flodin / Lars-Olof Hansson / Anders Larsson
Published Online: 2011-09-21 | DOI: https://doi.org/10.1515/CCLM.2006.271


Background: Cystatin C is increasingly used as a glomerular filtration marker, but so far only a few companies produce most of the cystatin C reagents suited for turbidimetry or nephelometry use in clinical laboratories.

Methods: We studied different protocols for measuring cystatin C on an Architect ci8200 system using cystatin C reagents from Dako (Glostrup, Denmark). The results were compared with those obtained with Dade Behring reagents (Deerfield, IL, USA) on a BN ProSpec system.

Results: Differences in assay protocol on the same instrument with the Dako reagent yielded an up to 50% difference in glomerular filtration rate calculated from the cystatin C results when analyzing patient samples, but had no effect on the results for controls. There were also significant differences regarding linearity and kinetics between samples and controls/calibrators.

Conclusions: The results indicate different reactivity of the Dako antibodies against calibrators and controls in comparison with patient samples, highlighting the importance of using controls and calibrators that do not differ from patient samples.

Clin Chem Lab Med 2006;44:1481–5.

Keywords: cystatin C; erroneous results; glomerular filtration ratio; immunoassay; kidney function; recombinant proteins; turbidimetry


  • 1.

    Kemperman FA, Krediet RT, Arisz L. Formula-derived prediction of the glomerular filtration rate from plasma creatinine concentration. Nephron 2002; 91:547–58.CrossrefGoogle Scholar

  • 2.

    Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976; 58:259–63.Google Scholar

  • 3.

    Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16:31–41.CrossrefGoogle Scholar

  • 4.

    Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130:461–70.Google Scholar

  • 5.

    Hsu CY, Chertow GM, Curhan GC. Methodological issues in studying the epidemiology of mild to moderate chronic renal insufficiency. Kidney Int 2002; 61:1567–76.CrossrefGoogle Scholar

  • 6.

    Sherman DS, Fish DN, Teitelbaum I. Assessing renal function in cirrhotic patients: problems and pitfalls. Am J Kidney Dis 2003; 41:269–78.CrossrefGoogle Scholar

  • 7.

    Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis 2002; 40:221–6.CrossrefGoogle Scholar

  • 8.

    Grubb A, Nyman U, Bjork J, Lindstrom V, Rippe B, Sterner G, et al. Simple cystatin C-based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the Counahan-Barratt prediction equations for children. Clin Chem 2005; 51:1420–31.CrossrefGoogle Scholar

  • 9.

    Larsson A, Malm J, Grubb A, Hansson LO. Calculation of glomerular filtration rate expressed in mL/min from plasma cystatin C values in mg/L. Scand J Clin Lab Invest 2004; 64:25–30.CrossrefGoogle Scholar

  • 10.

    Sjostrom P, Tidman M, Jones I. Determination of the production rate and non-renal clearance of cystatin C and estimation of the glomerular filtration rate from the serum concentration of cystatin C in humans. Scand J Clin Lab Invest 2005; 65:111–24.CrossrefGoogle Scholar

  • 11.

    Kort SA, Bouman AA, Nijhof JH, van Blerk IO, Blankenstein MA. Evaluation of two commercially available Cystatin C assays, Matrix effect? Clin Chem 2006; 52(Suppl):A158.Google Scholar

  • 12.

    Mergulhao FJ, Summers DK, Monteiro GA. Recombinant protein secretion in Escherichia coli. Biotechnol Adv 2005; 23:177–202.CrossrefGoogle Scholar

About the article

Corresponding author: Anders Larsson, Department of Medical Sciences, University Hospital, 751 85 Uppsala, Sweden Phone: +46-18-6110000, Fax: +46-18-552562,

Received: 2006-03-16

Accepted: 2006-09-26

Published Online: 2011-09-21

Published in Print: 2006-12-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 44, Issue 12, Pages 1481–1485, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2006.271.

Export Citation

©2006 by Walter de Gruyter Berlin New York.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Shruti Gupta, Sharon G. Curhan, Karen J. Cruickshanks, Barbara E.K. Klein, Ronald Klein, and Gary C. Curhan
The Laryngoscope, 2019
Alfons Ramel, Palmi V. Jonsson, Sigurbjorn Bjornsson, and Inga Thorsdottir
Nephron Clinical Practice, 2007, Volume 108, Number 1, Page c16
George J. Schwartz and Dana F. Work
Clinical Journal of the American Society of Nephrology, 2009, Volume 4, Number 11, Page 1832
Tom Nilsen, Siri Helen Haugen, and Anders Larsson
Health Science Reports, 2018, Page e35
Othman Ibrahem AlMusaimi, Abd-Alhakeem Hasan Abu-Nawwas, Danah Mahdi AlShaer, and Nabeel Yousef Khaleel
European Journal of Chemistry, 2017, Volume 8, Number 4, Page 378
Fatina I. Fadel, Abbass A. Mourad, Azza M. O. Abdel Rahman, Hafez M. Bazaraa, Mohamed Farouk Mohamed, Dalia H. El-Lebedy, and Mohamed M. Soliman
Pediatric Nephrology, 2017, Volume 32, Number 9, Page 1603
A.‐S. Jonsson, M. Flodin, L.‐O. Hansson, and A. Larsson
Scandinavian Journal of Clinical and Laboratory Investigation, 2007, Volume 67, Number 8, Page 801
Ulf Nyman, Jonas Björk, Sten-Erik Bäck, Gunnar Sterner, and Anders Grubb
European Radiology, 2016, Volume 26, Number 2, Page 425
L. Ghys, D. Paepe, P. Smets, H. Lefebvre, J. Delanghe, and S. Daminet
Journal of Veterinary Internal Medicine, 2014, Volume 28, Number 4, Page 1152
Liesbeth F. E. Ghys, Evelyne Meyer, Dominique Paepe, Joris Delanghe, and Sylvie Daminet
Veterinary Clinical Pathology, 2014, Volume 43, Number 2, Page 226
Pankaj Hari, Lakshmy Ramakrishnan, Ruby Gupta, Rakesh Kumar, and Arvind Bagga
Indian Pediatrics, 2014, Volume 51, Number 4, Page 273
G. J. Schwartz
Nephrology Dialysis Transplantation, 2014, Volume 29, Number 5, Page 944
Julien Obiols, Anne-Sophie Bargnoux, Nils Kuster, Pierre Fesler, Laurence Piéroni, Stéphanie Badiou, Anne-Marie Dupuy, Jean Ribstein, and Jean-Paul Cristol
Clinical Biochemistry, 2013, Volume 46, Number 15, Page 1542
George J. Schwartz, Michael F. Schneider, Paula S. Maier, Marva Moxey-Mims, Vikas R. Dharnidharka, Bradley A. Warady, Susan L. Furth, and Alvaro Muñoz
Kidney International, 2012, Volume 82, Number 4, Page 445
María Fernández García, Elisabeth Coll, Salvador Ventura Pedret, Carmen Bermudo Guitarte, María Cruz Cárdenas Fernández, Mariano Cortés Rius, Miguel García Montes, Cecília Martínez-Brú, David Pérez Surribas, Teresa Rodríguez González, Carmen Valldecabres Ortiz, José Antonio Viedma Contreras, and Edgar Zapico Muñiz
Revista del Laboratorio Clínico, 2011, Volume 4, Number 1, Page 50
N. Ristiniemi, C. Savage, L. Bruun, K. Pettersson, H. Lilja, and A. Christensson
Nephrology Dialysis Transplantation, 2012, Volume 27, Number 2, Page 682
Anders Larsson, Mats Flodin, Lars-Olof Hansson, and Lena Carlsson
Clinical Biochemistry, 2008, Volume 41, Number 16-17, Page 1355
Lesley A. Inker and Aghogho Okparavero
Current Opinion in Nephrology and Hypertension, 2011, Volume 20, Number 6, Page 631
Anne-Sophie Bargnoux, Marie Perrin, Valérie Garrigue, Stéphanie Badiou, Anne-Marie Dupuy, Georges Mourad, and Jean-Paul Cristol
Clinical Chemistry and Laboratory Medicine, 2012, Volume 50, Number 1
Pierre Delanaye, Laurence Pieroni, Christelle Abshoff, Laurence Lutteri, Jean-Paul Chapelle, Jean-Marie Krzesinski, Bernard Hainque, and Etienne Cavalier
Clinica Chimica Acta, 2008, Volume 398, Number 1-2, Page 118
Lars‐Olof Hansson, Mats Flodin, Tom Nilsen, Karin Caldwell, Karin Fromell, Kathrin Sunde, and Anders Larsson
Journal of Immunoassay and Immunochemistry, 2007, Volume 29, Number 1, Page 1
Lesley A. Stevens and Andrew S. Levey
American Journal of Kidney Diseases, 2009, Volume 53, Number 3, Page S17
Lesley A. Stevens, Josef Coresh, Christopher H. Schmid, Harold I. Feldman, Marc Froissart, John Kusek, Jerome Rossert, Frederick Van Lente, Robert D. Bruce, Yaping (Lucy) Zhang, Tom Greene, and Andrew S. Levey
American Journal of Kidney Diseases, 2008, Volume 51, Number 3, Page 395
James B. Wetmore, Runolfur Palsson, John M. Belmont, Gunnar Sigurdsson, Leifur Franzson, and Olafur S. Indridason
Scandinavian Journal of Urology and Nephrology, 2010, Volume 44, Number 4, Page 242
Anne-Sophie Bargnoux, Etienne Cavalier, Jean-Paul Cristol, Noémie Simon, Anne-Marie Dupuy, Valérie Garrigue, Stéphanie Badiou, Pierre Delanaye, and Georges Mourad
Clinical Chemistry and Laboratory Medicine, 2011, Volume 49, Number 2
Sophie Séronie-Vivien, Pierre Delanaye, Laurence Piéroni, Christophe Mariat, Marc Froissart, and Jean-Paul Cristol
Clinical Chemistry and Laboratory Medicine, 2008, Volume 46, Number 12

Comments (0)

Please log in or register to comment.
Log in