Effect of heparin treatment on plasma albumin quantification by Bromcresol Green method

Nguyen Thi Thanh Hai, Nguyen Hoang Phuong

Main Article Content

Abstract

This is a cross-sectional descriptive study evaluating the bias between two albumin quantification methods, BCG (Bromocresol Green) and BCP (Bromocresol Purple) on plasma samples of patients with or without heparin treatment. The study was conducted on 272 patient samples with or without heparin treatment to compare albumin quantification results using both BCG and and the reference method BCP which was demonstrated not to be interfered by heparin. Results of albumin concentration quantified by the BCG method was on average 15.1% higher than the BCP method (95%CI: 13.3% - 16.8%). Discrepancies in the sample of patients receiving heparin were a total of 19.35% (95%CI: 15.2% - 23.5) and 29.39% (95%CI: -34.07 - -24.71) in cases of albumin concentration < 25 g/L.

Article Details

References

1. Bachmann LM, Yu M, Boyd JC, Bruns DE, et al. State of Harmonization of 24 Serum Albumin Measurement Procedures and Implications for Medical Decisions. Clin Chem. Mar 2017;63(3):770-779. doi:10.1373/clinchem.2016.262899
2. Kumar D, Banerjee D. Methods of albumin estimation in clinical biochemistry: Past, present, and future. Clin Chim Acta. Jun 2017;469:150-160. doi:10.1016/j.cca.2017.04.007
3. van de Logt AE, Rijpma SR, Vink CH, et al. The bias between different albumin assays may affect clinical decision-making. Kidney Int. Jun 2019;95(6):1514-1517. doi:10.1016/j.kint.2019.01.042
4. Parikh C, Yalavarthy R, Gurevich A, et al. Discrepancies in serum albumin measurements vary by dialysis modality. Ren Fail. Sep 2003;25(5):787-96. doi:10.1081/jdi-120024294
5. Kok MB, Tegelaers FP, van Dam B, et al. Carbamylation of albumin is a cause for discrepancies between albumin assays. Clin Chim Acta. Jul 01 2014;434:6-10. doi:10.1016/j.cca.2014.03.035
6. van Schrojenstein Lantman M, van de Logt AE, Prudon-Rosmulder E, et al. Albumin determined by bromocresol green leads to erroneous results in routine evaluation of patients with chronic kidney disease. Clin Chem Lab Med. Nov 27 2023;61(12):2167-2177. doi:10.1515/cclm-2023-0463
7. Stokol T, Tarrant JM, Scarlett JM. Overestimation of canine albumin concentration with the bromcresol green method in heparinized plasma samples. Vet Clin Pathol. 2001;30(4):170-176. doi:10.1111/j.1939-165x.2 001.tb00427.x
8. Perry BW, Doumas BT. Effect of heparin on albumin determination by use of Bromcresol Green and Bromcresol Purple. Clin Chem. Aug 1979;25(8):1520-2.
9. Hardy MJ, Bjurström CH. Effect of heparin on determination of plasma albumin by Beckman Astra 8 (BCG) and Du Pont ACA II (BCP) autoanalysers. Ann Clin Biochem. Sep 1984;21 ( Pt 5):387-8. doi:10.1177/000456328402100508
10. Hallbach J, Hoffmann GE, Guder WG. Overestimation of albumin in heparinized plasma. Clin Chem. Apr 1991;37(4):566-8.
11. Northam BE, Widdowson GM. Association of Clinical Biochemists. Study Group on Automation in Clinical C. Determination of Serum Albumin by Autoanalyzer Using Bromocresol Green. Technical bulletin (Association of Clinical Biochemists Scientific and Technical Committee). Association of Clinical Biochemists, Scientific and Technical Committee; 1967.
12. Northam BE. Whither automation? Ann Clin Biochem. Jul 1981;18(Pt 4):189-99. doi:10.1177/000456328101800401
13. Brackeen GL, Dover JS, Long CL. Serum albumin. Differences in assay specificity. Nutr Clin Pract. Dec 1989;4(6):203-5. doi:10.1177/0115426589004006203
14. Gustafsson JE. Improved specificity of serum albumin determination and estimation of “acute phase reactants” by use of the bromcresol green reaction. Clin Chem. May 1976;22(5):616-22.
15. Parmar A, Agarwal D, Saha TK, et al. Choice of Assay Affects Serum Albumin Measurements in HIV Patients: A Comparison of Bromocresol Green and Bromocresol Purple Dye Binding Methods. Medical Journal of Dr DY Patil University. 2023;16(5)
16. Ueno T, Hirayama S, Ito M, et al. Albumin concentration determined by the modified bromocresol purple method is superior to that by the bromocresol green method for assessing nutritional status in malnourished patients with inflammation. Ann Clin Biochem. Nov 2013;50(Pt 6):576-84. doi:10.1177/0004563213480137
17. Speicher CE, Widish JR, Gaudot FJ, et al. An evaluation of the overestimation of serum albumin by bromcresol green. Am J Clin Pathol. Mar 1978;69(3):347-50. doi:10.1093/ajcp/69.1.347
18. Xu Y, Wang L, Wang J, et al. Serum globulins contribute to the discrepancies observed between the bromocresol green and bromocresol purple assays of serum albumin concentration. Br J Biomed Sci. 2011;68(3):120-5. doi:10.1080/09674845.2011.11730338
19. Akoglu H. User’s guide to correlation coefficients. Turk J Emerg Med. Sep 2018;18(3):91-93. doi:10.1016/j.tjem.2018.08.001