, Volume 34, Issue 5, pp 973-974
Date: 19 Dec 2007

Acetylcysteine and enzymatic creatinine: beware of laboratory artefact!

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Sir: N-Acetylcysteine (NAC) is an antioxidant agent used as a mucolytic and to prevent acute hepatic failure following paracetamol poisoning [1]. NAC has also been thought to prevent radiocontrast nephrotoxicity [2]. Potential analytical interferences between NAC and creatinine measurement have been poorly studied. Tepel et al. showed no interference between their Jaffé creatinine and NAC in vitro [2]. Enzymatic methods are more precise and specific for creatinine measurement than the classic Jaffé methods [3]. Enzymatic assays are thus recommended. However, creatinine enzymatic assays are not free from interference, as has been described with flucytosine and high doses of dobutamine [3].

We have studied, in vitro, potential interferences between NAC and creatinine measurement by Jaffé and enzymatic methods. We decided to study three serum pools with creatinine concentrations around 1, 2 and 4.5 mg/dl. Each sample was analysed in duplicate before and directly after adding increasing dos