English 
Italian Valutazione critica e meta-analisi delle stime di variabilità biologica degli analiti relativi alle patologie renali
Critical appraisal and meta-analysis of biological variation estimates for kidney related analytes
AUTORI
Elisabet Gonzalez-Lao11, Joana Minchinela12, Carmen Perich5, Margarita Simón13, Sverre Sandberg14, Aasne K. Aarsand15, on behalf of the European Federation of Clinical Chemistry and Laboratory Medicine Working Group on Biological Variation and Task Group for the Biological Variation Database 1Certe-Wilhelmina Ziekenhuis Assen, Europaweg-Zuid 1, 9401 RK, Assen, The Netherlands
2Institute for Quality Management in Healthcare (IQMH), Centre for Proficiency Testing, Toronto, Ontario, Canada
3Spanish Society of Laboratory Medicine (SEQCML), Analytical Quality Commission, Barcelona, Spain; Royo Villanova Hospital, Zaragoza, Spain
4Spanish Society of Laboratory Medicine (SEQCML), Analytical Quality Commission, Barcelona, Spain; Department of Clinical Biochemistry, UniversityHospital of Salamanca, Salamanca, Spain
5Spanish Society of Laboratory Medicine (SEQCML), Analytical Quality Commission, Barcelona, Spain
6School of Medicine, University of Dundee, Dundee, Scotland, UK
17Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
8Servizio Medicina di Laboratorio, Ospedale San Raffaele, Milan, Italy
9Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
10Spanish Society of Laboratory Medicine (SEQCML), Analytical Quality Commission, Barcelona, Spain; Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
11SpanishSociety of LaboratoryMedicine(SEQCML), Analytical Quality Commission, Barcelona, Spain; Quality Healthcare Consulting, Grupo ACMS, Madrid, Spain
12Spanish Society of Laboratory Medicine (SEQCML), Analytical Quality Commission, Barcelona, Spain; Metropolitana Nord Unified Laboratory (LUMN), Germans Trias i Pujol University Hospital, Badalona, Spain
13Spanish Society of Laboratory Medicine (SEQCML), Analytical Quality Commission, Barcelona, Spain; Consortium of Laboratory Intercomarcal Alt Pened`es and Garraf l’Anoia, Vilafranca del Pened`es, Spain
14Norwegian Porphyria Centre, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway; Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway; and Department of Global Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
15Norwegian Porphyria Centre, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway; Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway
Traduzione a cura di Anna Carobene (Ospedale San Raffaele, Milano)
ABSTRACT
Critical appraisal and meta-analysis of biological variation estimates for kidney related analytes
Objective: Kidney markers are some of the most frequently used laboratory tests in patient care, and correct clinical decision making depends upon knowledge and correct application of biological variation (BV) data. The aim of this study was to review available BV data and to provide updated BV estimates for the following kidney markers in serum and plasma; albumin, creatinine, cystatin C, chloride, potassium, sodium and urea.
Content: Relevant studies were identified from a historical BV database as well as by systematic literature searches. Retrieved publications were appraised by the Biological Variation Data Critical Appraisal Checklist (BIVAC). Metaanalyses of BIVAC compliant studies with similar design were performed to deliver global estimates of within-subject (CVI) and between-subject (CVG) BV estimates. Out of the 61 identified papers, three received a BIVAC grade A, four grade B, 48 grade C, five grade D grade and one was not appraised as it did not report numerical BV estimates. Most studies were identified for creatinine (n=48). BV estimates derived from the meta-analysis were in general lower than previously reported estimates for all analytes except urea. For some measurands, BV estimates may be influenced by age or states of health, but further data are required.
Summary: This review provides updated global BV estimates for kidney related measurands. For all measurands except for urea, these estimates were lower than previously reported.
Outlook: For the measurands analyzed in this review, there are sufficient well-designed studies available to publish a trustworthy estimate of BV. However, for a number of newly appearing kidney markers no suitable data is available and additional studies are required.