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IDMS to Conventional Serum Creatinine

Converts IDMS values to the conventional serum
creatinine assay
 ClinCalc.com (/) » Nephrology (/Nephrology) » IDMS to Conventional Serum Creatinine

IDMS Creatinine Assay

IDMS () Creatinine 1.20 mg/dL

Reset Calculate

 US units

RESULTS

Serum creatinine assay conversion:

IDMS ()   Conventional

1.20 mg/dL  1.34 mg/dL

Save Image
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 5 30%

Percent Difference (%)

Conventional (mg/dL)
20%
3

2
10%

1
Mathematical Calculation
0 0%
1 DM S S C r)2∗ 1.065 + 0.067
C onventional S C r (mg/dL) = (I 3

IDMS (mg/dL)

 About This Calculator

In order to estimate a patient's glomerular filtration rate (GFR), a blood sample is collected and the
amount of creatinine is measured. In conjunction with mathematical equations, usually Cockcroft-
Gault (1976) (CrCl.aspx#CockcroftGault1976), a creatinine clearance is estimated, which correlates
closely to GFR.

Historically, serum creatinine was measured using "conventional" (older) assay methods, such as the
alkaline picrate method. Although extensively used, this assay detects "non-creatinine chromogens"
(chemicals that are not creatinine) and results in a falsely elevated laboratory result. 1

The NKDEP () guidelines 2 recommend that all laboratories convert their systems to use a newer, more
accurate assay method called IDMS (). IDMS () does not detect non-creatinine chromogens, resulting
in a more accurate, but lower serum creatinine value than the conventional assay.

Correction for Bias

Prior to widespread adoption of IDMS (), modeling estimates of creatinine clearance were based on
"conventional" assays. Estimates of glomerular filtration rate, such as the Cockcroft-Gault equation,
were developed using the older assay that could be falsely elevated by 20% or higher compared to the
more accurate IDMS () method. In order to still use these classic equations to estimate creatinine
clearance, an IDMS-based serum creatinine value should be "converted" to a conventional value using
the following equation: 3

C onventional S C r (mg/dL) = (I DM S S C r) ∗ 1.065 + 0.067

Degree of Conventional-IDMS Agreement

As shown in the graph below, the percent difference between the conventional serum creatinine assay
method and IDMS () is greatest at low serum creatinine values (about 20% different) and progressively
declines to a difference of about 10% for serum creatinine values above about 1.2 mg/dL. Given the
 inherent error in estimating creatinine clearance using Cockcroft-Gault, this percent difference is
unlikely to have a clinical impact, but should be account for in electronic clinical decision support tools.
All calculators on ClinCalc.com (//clincalc.com) support the ability to specify a serum creatinine
value as IDMS or non-IDMS.

Save Image
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5 30%

Percent Difference (%)

Conventional (mg/dL)

20%
3

2
10%

0 0%
1 2 3

IDMS (mg/dL)

The Future with IDMS ()

According to the NKDEP (), almost all laboratories are expected to convert to the IDMS () method by
the end of 2010. This shift in laboratory standards has already been implemented in modern estimates
of glomerular filtration rate. The MDRD equation (CrCl.aspx#MDRD4), used to calculate "eGFR", was
originally developed using a conventional serum creatinine assay and later was republished using
IDMS-based values. The update to MDRD, called the CKD-EPI equation (CrCl.aspx#CKDEPI2009),
exclusively relies on IDMS-based values only.

 References and Additional Reading

1. Spruill WJ, Wade WE, Cobb HH 3rd. Estimating glomerular filtration rate with a modification of
diet in renal disease equation: implications for pharmacy. Am J Health Syst Pharm.
2007;64(6):652-60. PMID 17353576 (http://www.ncbi.nlm.nih.gov/pubmed/17353576) .
2. National Kidney Disease Education Program. Chronic Kidney Disease and Drug Dosing:
Information for Providers. Available at http://www.nkdep.nih.gov/.../CKD_DrugDosing_508.pdf
(http://www.nkdep.nih.gov/professionals/CKD_DrugDosing_508.pdf) . Updated January 2010.
Accessed December 18, 2011.
3. Ortho-Clinical Diagnostics. Updated Information for IDMS Traceable VITROS® Chemistry
Products CREA Slides. June 12, 2008. Written communication available for download
(../Downloads/OrthoClinicalDiagnostics-IDMS_20080612.pdf).
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