Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jul 9, 2021; 10(4): 72-78
Published online Jul 9, 2021. doi: 10.5409/wjcp.v10.i4.72
Indirect determination of serum creatinine reference intervals in a Pakistani pediatric population using big data analytics
Sibtain Ahmed, Jakob Zierk, Imran Siddiqui, Aysha Habib Khan
Sibtain Ahmed, Imran Siddiqui, Aysha Habib Khan, Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi 74800, Sindh, Pakistan
Jakob Zierk, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen 91054, Germany
Author contributions: Ahmed S designed and conceived the idea, performed the literature review/comparison, interpreted the data and performed the majority of the write up in the first draft; Zierk J performed the statistical analysis, assisted in the write up of the first draft and critically reviewed the manuscript; Siddiqui I critically analyzed the results and reviewed the manuscript; Khan AH assisted with data acquisition and critically reviewed the manuscript; all the authors have accepted responsibility for the entire content of the submitted manuscript and approved submission.
Institutional review board statement: Ethical approval for the study was obtained from the Ethical review committee of the Aga Khan University, No. 5348-Pat-ERC-18.
Informed consent statement: Not applicable as no intervention was undertaken and only laboratory test results were statistically analyzed keeping patient identification anonymized.
Conflict-of-interest statement: There are nothing to declare.
Data sharing statement: Dataset available from the corresponding author at sibtain.ahmed@aku.edu. Consent was not obtained as the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sibtain Ahmed, FCPS, MBBS, Assistant Professor, Department of Pathology and Laboratory Medicine, The Aga Khan University, Sopari Wala Building, Stadium Road, Karachi 74800, Sindh, Pakistan. sibtain.ahmed@aku.edu
Received: January 20, 2021
Peer-review started: January 20, 2021
First decision: February 15, 2021
Revised: February 16, 2021
Accepted: April 20, 2021
Article in press: April 20, 2021
Published online: July 9, 2021
Abstract
BACKGROUND

The indirect methods of reference intervals (RI) establishment based on data mining are utilized to overcome the ethical, practical challenges and the cost associated with the conventional direct approach.

AIM

To generate RIs for serum creatinine in children and adolescents using an indirect statistical tool.

METHODS

Data mining of the laboratory information system was performed for serum creatinine analyzed from birth to 17 years for both genders. The timeline was set at six years from January 2013 to December 2018. Microsoft Excel 2010 and an indirect algorithm developed by the German Society of Clinical Chemistry and Laboratory Medicine’s Working Group on Guide Limits were used for the data analysis.

RESULTS

Data were extracted from 96104 samples and after excluding multiple samples for the same individual, we calculated RIs for 21920 males and 14846 females, with stratification into six discrete age groups.

CONCLUSION

Serum creatinine dynamics varied significantly across gender and age groups.

Keywords: Creatinine, Pediatric, Reference intervals, Indirect, Data mining, Pakistan

Core Tip: Good laboratory practices advocate the necessity for generation of population specific reference intervals (RIs). The indirect methods of RIs establishment based on data mining are utilized to overcome the ethical, practical challenges and the cost associated with the conventional direct approach. The population specific RIs generated for pediatric serum creatinine levels in this study will assist in more accurate comprehension of the variations in creatinine and facilitate patient care.