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Citric acid and its conjugate base sodium citrate leads to false low uric acid (UA) measurements in gout patients

Citric acid and its conjugate base sodium citrate leads to false low uric acid (UA) measurements in gout patients Citric acid and its conjugate base sodium citrate leads to false low uric acid (UA) measurements in gout patients
Citric acid and its conjugate base sodium citrate leads to false low uric acid (UA) measurements in gout patients Citric acid and its conjugate base sodium citrate leads to false low uric acid (UA) measurements in gout patients

What's new?

ACD and SC tubes containing citric acid should not be used to measure UA levels, as citric acid decreases the amount of oxidized leuco dye which leads to false UA measurements.

As citric acid and sodium citrate hinder the actual uricase-based UA measurement, therefore instead of ACD and SC tubes, SST tubes should prefer while detecting serum UA, evident from the findings of a newly issued study in the Journal of Pharmaceutical and Biomedical Analysis. After noting considerable differences between UA concentrations of blood samples collected by different collection tubes, this study was led to determine the impact of exogenous tube components on calculated UA concentrations.

Blood samples were obtained in Sodium Citrate (SC) tubes, Serum Separator Tubes (SST tubes), and Acid Citrate Dextrose (ACD) tubes and uricase method was used to measure the circulating UA concentrations. Impact of dextrose, citric acid and sodium citrate in the presence of peroxidase, violet dye, and hydrogen peroxide determined by absorbance assays.

As compared to the SST tubes, UA concentrations collected in ACD and SC tubes were found to be lower. Further, different concentration of citric acid, dextrose and sodium citrate demonstrated significantly lower UA measurements than controls. In the presence of leuco crystal violet, hydrogen peroxide, and peroxidase, absorbance assays showed that increased concentrations of citric acid and sodium citrate associated with the reduced amount of oxidized dye in the uricase method of UA measurement in a dose-dependent manner. The reason behind this was the scavenging of hydrogen peroxide by citric acid, and this reduces the quantity of oxidized leuco dye which leads to false low UA measurements. However, dextrose was not associated with the altered amount of oxidized dye. Therefore, the ACD and SC tubes should not be used while measuring the UA through uricase measurement methods.

Source:

J Pharm Biomed Anal

Article:

Antioxidant properties of citric acid interfere with the uricase-based measurement of circulating uric acid.

Authors:

Evan M. Ryan et al.

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