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Annual Report of the Korean Association of External Quality Assessment Service on General Chemistry (2018)
J Lab Med Qual Assur 2019;41:51-64
Published online June 30, 2019
© 2019 Korean Association of External Quality Assessment Service.

Yong-Wha Lee

Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
Correspondence to: Yong-Wha Lee, Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaruro, Wonmi-gu, Bucheon 14584, Korea, Tel: +82-32-621-5943 Fax: +82-32-621-5944 E-mail: lywmd@schmc.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

In 2018, the general chemistry proficiency testing program of the Korean Association of External Quality Assessment Service consisted of the routine chemistry and urine chemistry programs including 32 and 13 test items, respectively. The test method classification system was revised in the routine chemistry program, and a qualitative test of human chorionic gonadotropin was added in the urine chemistry program. The routine chemistry program was conducted 4 times a year, while the urine chemistry program was conducted twice a year. Statistical analysis data for the test method and reagent companies were reported based on the information and results of the test items provided by each institution. Statistics included the number of participating institutes, mean, standard deviation, coefficient of variation (CV), median, and minimum and maximum values for each group. Each report included tables, histograms, Levey-Jennings charts, and the standard deviation index showing the statistics of each test item. In the routine chemistry program, more than 1,000 institutions performed the 17 test items, and the number is continuously increasing. CV for each test item showed a tendency to increase with decreasing concentration of the proficiency material but was within 10% in most cases. Alkaline phosphatase and lactate dehydrogenase were found to have relatively high CVs because of the differences in results among test methods. In the urine chemistry program, albumin and protein showed high CVs, and the distribution of the test method was different from that of the routine chemistry program.

Keywords : Proficiency testing, General chemistry, Korean Association of External Quality Assessment Service
꽌濡

븳엫긽寃궗젙룄愿由ы삊쉶뿉꽌뒗 2016뀈遺꽣 깉濡쒖슫 슫쁺諛⑹떇쓽 李⑥꽭 떊鍮숇룄議곗궗궗뾽쓣 떆뻾븯怨 엳떎. 2018뀈뿉뒗 6媛 遺꾨쪟븯뿉 64媛 봽濡쒓렇옩 떒쐞蹂 슫쁺泥닿퀎濡 솗릺뼱 봽濡쒓렇옩蹂 寃궗醫낅ぉ룄 319빆紐⑹쑝濡 利앷븯떎[1-3]. 엫긽솕븰 遺꾩빞뒗 6媛쒖쓽 遺꾨쪟 以 븯굹濡쒖꽌 씪諛섑솕븰寃궗 벑 10 媛쒖쓽 以묐텇瑜 遺꾩빞濡 援ъ꽦릺怨 씠뱾 씪諛섑솕븰寃궗 슂솕븰 寃궗 벑 24媛쒖쓽 꽭遺 봽濡쒓렇옩쑝濡 굹돏떎. 씪諛섑솕븰寃궗 봽濡쒓렇옩뿉뒗 珥 32醫낆쓽 寃궗빆紐⑹씠 룷븿릺뼱 엳怨, 슂솕븰寃궗 봽濡쒓렇옩뿉뒗 슂 human chorionic gonadotropin (hCG) 젙꽦寃궗媛 異붽릺뼱 珥 13醫낆쓽 寃궗빆紐⑹씠 룷븿릺뿀떎. 씪諛섑솕븰寃궗 봽濡쒓렇옩뿉 빐꽌뒗 寃궗빆紐⑸퀎濡 깉濡쒖슫 寃궗諛⑸쾿 遺꾨쪟泥닿퀎瑜 쟻슜븯뿬 媛곴컖쓽 떆빟뱾뿉 빐 깉濡쒖슫 寃궗諛⑸쾿 紐낆묶쓣 遺뿬븯떎.

옄뱾 2018뀈 븳엫긽寃궗젙룄愿由ы삊쉶쓽 떊鍮숇룄議곗궗 궗뾽쑝濡 떎떆릺뿀뜕 씪諛섑솕븰寃궗 슂솕븰寃궗뿉 븳 떊鍮숇룄議곗궗궗뾽 寃곌낵瑜 遺꾩꽍븯뿬 蹂닿퀬븯怨좎옄 븳떎.

옱猷 諛 諛⑸쾿

1. 긽

씪諛섑솕븰寃궗 봽濡쒓렇옩 뿰 4쉶뿉 嫄몄퀜 쉶李⑤퀎濡 3媛쒖쓽 젙룄愿由щЪ吏덉씠 씠슜릺뼱 떆뻾릺뿀떎. 臾쇱쭏 깋옣긽깭媛 쑀吏맆 닔 엳룄濡 븘씠뒪뙥씠 궡옣맂 듅닔 젣옉諛뺤뒪뿉 꽔뼱 李몄뿬 벑濡앷린愿쓣 긽쑝濡 媛 쉶李⑤퀎濡 2썡, 4썡, 8썡怨 10썡뿉 諛쒖넚릺뿀떎. 슂솕븰寃궗 봽濡쒓렇옩 뿰 2쉶뿉 嫄몄퀜, 쉶李 蹂꾨줈 3媛쒖쓽 젙룄愿由 臾쇱쭏씠 씠슜릺뿀怨 1쉶李⑥ 2쉶李⑤ 媛곴컖 3썡怨 9썡뿉 諛쒖넚븯떎.

2. 젙룄愿由щЪ吏덇낵 寃궗빆紐

씪諛섑솕븰寃궗쓽 젙룄愿由щЪ吏덉 궗엺 삁泥쓣 湲곗쭏濡 븳 遺 留먯젣뭹씤 Randox궗(Randox Testing Services, London, UK) Bio-Rad궗(Bio-Rad Laboratories, Hercules, CA, USA)쓽 궗엺 삁泥쓣 湲곗쭏濡 븳 遺꾨쭚젣뭹쓣 궗슜븯떎 (Table 1). 寃궗빆紐⑹ 꽦씤怨 냼븘쓽 異붿젙 궗援ъ껜뿬怨쇱쑉 빆紐⑹쓣 룷븿븯뿬 珥 32빆紐⑹씠뿀떎. 슂솕븰寃궗쓽 젙룄愿由щЪ吏덉 Bio-Rad궗쓽 Lyphochek Quantitative Urine Control (Bio-Rad Laboratories)쓣 궗슜븯떎(Table 2). 궗쟾뿉 怨듭맂 씪젙뿉 뵲씪 臾쇱쭏쓣 닔졊븳 李몄뿬湲곌뿉꽌뒗 寃궗 떆뻾 썑 吏젙맂쉶떊 留덇컧씪 씠궡뿉 븳엫긽寃궗젙룄愿由ы삊쉶 떊鍮숇룄議곗궗궗뾽 솃럹씠吏(http://eqas.keqas.org)뿉 寃곌낵瑜 엯젰븯룄濡 븯떎. 湲곌린쉶궗 떆빟쉶궗濡쒕꽣 젣怨듬맂 寃궗빆紐⑸퀎 寃궗諛⑸쾿, 湲곌린 떆빟뿉 빐 湲곗큹옄猷뚮 寃넗븳 諛붾 넗濡 李몄뿬 湲곌씠 솃럹씠吏긽뿉꽌 빐떦 寃궗빆紐⑹뿉 븳 寃궗젙蹂 꽑깮怨 寃곌낵 엯젰씠 媛뒫븯룄濡 쟾궛泥닿퀎瑜 援ъ텞븯떎. 寃곌낵 엯젰 湲곌컙 궡뿉 理쒖쥌 쟾넚쓣 뻽뜑씪룄 寃곌낵 닔젙씠 媛뒫븯룄濡 븯떎.

Table 1 . Control materials analyzed and released dates from the trials of general chemistry in 2018.

TrialMaterial no.ManufacturerProduct nameLot no.Released date
1stCC-18-01RandoxHuman low serum 5 mL273ULCM26 February
CC-18-02RandoxHuman normal serum 5 mL1250UNCM
CC-18-03RandoxHuman elevated serum 5 mL973UECM
2ndCC-18-04RandoxHuman low serum 5 mL274ULCM23 April
CC-18-05RandoxHuman normal serum 5 mL1251UNCM
CC-18-06RandoxHuman elevated serum 5 mL974UECM
3rdCC-18-07Bio-RadLyphochek assayed & unassayed chemistry control2644120 August
CC-18-08Bio-RadLyphochek assayed & unassayed chemistry control26442
CC-18-09Bio-RadLyphochek assayed & unassayed chemistry control26432
4thCC-18-10Bio-RadLyphochek assayed & unassayed chemistry control288311 October
CC-18-11Bio-RadLyphochek assayed & unassayed chemistry control28832
CC-18-12Bio-RadLyphochek assayed & unassayed chemistry control26452

The instruments were from the following companies: Randox Laboratories (London, UK) and Bio-Rad Laboratories (Hercules, CA, USA). .


Table 2 . Control materials analyzed and released dates from the trials of urine chemistry in 2018.

TrialMaterial no.ManufacturerProduct nameLot no.Released date
1stCUC-18-01Bio-RadLyphochek quantitative urine control6338112 March
CUC-18-02Bio-RadLyphochek quantitative urine control63382
CUC-18-03Bio-RadLyphochek quantitative urine control63383
2ndCUC-18-04Bio-RadLyphochek quantitative urine control6342110 September
CUC-18-05Bio-RadLyphochek quantitative urine control63422
CUC-18-06Bio-RadLyphochek quantitative urine control63411

The instruments were from the following company: Bio-Rad Laboratories (Hercules, CA, USA). .


3. 寃궗踰 떊遺꾨쪟泥닿퀎 쟻슜

씪諛섑솕븰寃궗 봽濡쒓렇옩쓽 寃궗빆紐⑸퀎 寃궗諛⑸쾿 遺꾨쪟泥닿퀎쓽 쁽솴怨 湲곌린떆빟蹂 吏젙맂 寃궗諛⑸쾿怨 룞猷뚯쭛떒 꽕젙긽쓽 媛쒖꽑젏쓣 遺꾩꽍븯怨, 씪諛섑솕븰寃궗 愿젴 援궡·쇅 二쇱슂 愿젴 옄猷뚯 臾명뿄 諛 寃궗湲곌린 떆빟뾽泥대줈遺꽣 젣怨듬릺뒗 꽕紐낆꽌瑜 寃넗븿쑝濡쒖뜥 李멸湲곌뿉꽌 젣怨듯븯뒗 寃궗諛⑸쾿뿉 븳 젙蹂 諛 떊鍮숇룄議곗궗 寃곌낵뿉 빐꽌 젙솗븳 룞猷뚯쭛떒 遺꾨쪟 諛 넻怨꾨텇꽍쓽 湲곗큹媛 맆 닔 엳뒗 깉濡쒖슫 寃궗諛⑸쾿 紐낆묶怨 遺꾨쪟泥닿퀎瑜 젙由쏀븯뿬 씪諛섑솕븰寃궗 봽濡쒓렇옩뿉 쟻슜븯떎.

4. 寃곌낵 뙋젙 諛 遺꾩꽍

씪諛섑솕븰寃궗 슂솕븰寃궗 媛곴컖뿉 빐꽌 媛 湲곌뿉꽌 엯젰븳 媛 寃궗빆紐⑹뿉 븳 젙蹂댁 寃곌낵瑜 湲곕컲쑝濡 寃궗諛⑸쾿, 湲곌린, 떆빟뿉 뵲씪 넻怨꾨텇꽍쓣 떆뻾븯怨 씠瑜 쟾泥 李몄뿬湲곌쓽 듅꽦쓣 蹂댁뿬二쇰뒗 怨듯넻蹂닿퀬꽌 媛쒕퀎湲곌쓽 룊媛옄猷뚮 蹂댁뿬二쇰뒗 湲곌蹂 蹂닿퀬꽌濡 굹늻뼱 蹂닿퀬븯떎. 怨듯넻蹂닿퀬꽌뒗 3떒怨꾨줈 洹몃9솕븯뿬 넻怨꾩튂瑜 젣떆븯떎. 쟾泥 李몄뿬湲곌뿉 빐떦븯뒗 넻怨, 寃궗諛⑸쾿쓣 湲곗遺꾨쪟濡 븳 洹몃9쓽 넻怨꾩 寃궗諛 踰뺣퀎濡 떆빟쉶궗瑜 꽭 遺꾨쪟븳 洹몃9쓽 넻怨꾨 媛곴컖 젣떆븯떎. 젣떆맂 넻怨꾩뿉뒗 媛 洹몃9蹂 李몄뿬湲곌 닔, 룊洹, 몴以렪李, 蹂 룞怨꾩닔, 以묒븰媛, 理쒖냼媛믨낵 理쒕媛믪씠 룷븿릺룄濡 븯怨 李몄뿬 湲곌 닔, 以묒븰媛, 理쒖냼媛믨낵 理쒕媛믪 씠긽移섎 젣嫄고븯吏 븡 닔移섎 젣떆븯怨 룊洹, 몴以렪李⑥ 蹂룞怨꾩닔뒗 媛 洹몃9蹂꾨줈 씠긽移섎 젣嫄고븳 썑 궛異쒕맂 닔移섎 궗슜븯떎. 삉븳 빐떦 遺꾨쪟뿉꽌 씠긽移섎 젣嫄고븳 썑 湲곌 닔媛 8媛 誘몃쭔씤 寃쎌슦 룊洹, 몴以렪李⑥ 蹂룞怨꾩닔瑜 젣떆븯吏 븡븯怨 湲곌 닔媛 3媛 誘몃쭔씤 寃쎌슦 以묒븰媛믩룄 젣떆븯吏 븡븯떎. 씠긽移섎뒗 媛 빐떦 遺꾨쪟 뿉꽌 75띁꽱씪 媛(Q3)怨 25띁꽱씪 媛(Q1)쓽 李(Q3-Q1, interquartile range [IQR])쓽 1.5諛곕 珥덇낵븯뿬 Q1蹂대떎 궙嫄곕굹 Q3蹂대떎 넂 寃곌낵媛(<Q1-1.5×IQR 삉뒗 >Q3+1.5× IQR)쑝濡 꽕젙븯떎.

媛쒕퀎蹂닿퀬꽌뒗 媛 寃궗빆紐⑸퀎濡 넻怨꾩튂瑜 蹂댁뿬二쇰뒗 몴, 엳뒪넗洹몃옩怨 젅鍮-젣떇뒪 李⑦듃濡 援ъ꽦릺룄濡 븯떎. 넻怨꾩튂瑜 젣떆븳 몴뿉뒗 媛 湲곌쓽 寃곌낵媛믨낵 媛 遺꾨쪟蹂 넻怨꾩튂瑜 젣떆븯怨 湲곗遺꾨쪟 꽭遺꾨쪟뿉꽌뒗 몴以렪李⑥닔(standard deviation index, SDI)瑜 븿猿 젣떆븯떎. 쟾泥 寃곌낵뿉 빐꽌뒗 SDI瑜 젣떆븯吏 븡븯怨 媛 洹몃9뿉꽌 씠긽移 젣嫄 썑 湲곌 닔媛 8媛 誘몃쭔씪 寃쎌슦 SDI瑜 젣떆븯吏 븡븯떎. 몴以렪李④ 0씠吏留 湲곌쓽 寃곌낵媛믪씠 룊洹좉낵 떎瑜 寃쎌슦뿉룄 SDI瑜 젣떆븯吏 븡븯떎.

엳뒪넗洹몃옩뿉꽌뒗 쟾泥 湲곌쓽 遺꾪룷 湲곗 遺꾨쪟蹂 遺꾪룷瑜 젣떆븯怨 媛 湲곌쓽 쐞移섎 몴떆븯떎. 젅鍮-젣떇뒪 李⑦듃뒗 湲곗 遺꾨쪟蹂 SDI瑜 씠슜븯뿬 옉꽦븯떎.

寃곌낵 諛 怨좎같

2018뀈 씪諛섑솕븰寃궗 봽濡쒓렇옩쓽 듅吏뺤쑝濡 寃궗빆紐⑸퀎濡 깉濡쒖슫 寃궗諛⑸쾿 紐낆묶怨 遺꾨쪟泥닿퀎瑜 쟻슜븯뿬 씠瑜 湲곕컲쑝濡 넻怨꾨텇꽍 諛 寃곌낵瑜 蹂닿퀬븳 젏怨 슂솕븰寃궗 봽濡쒓렇옩뿉 슂 hCG 젙꽦寃궗瑜 異붽븳 젏쓣 뱾 닔 엳떎. 湲곗〈 寃궗諛⑸쾿 遺꾨쪟 泥닿퀎濡쒖꽌뒗 닔슜 븞 릺뒗 떆빟씠 利앷븿뿉 뵲씪 寃궗諛⑸쾿쓣 湲고 諛⑸쾿쑝濡 꽑깮븯뒗 궗濡媛 利앷븯怨, 씪遺 寃궗빆紐⑹뿉 빐꽌 쁽옱뿉뒗 궗슜릺吏 븡뒗 怨쇨굅쓽 寃궗諛⑸쾿씠 洹몃濡 쟻슜 릺嫄곕굹 젣議곗궗 紐낆묶씠 寃궗諛⑸쾿 紐낆묶쑝濡 궗슜맂 궗濡媛 엳뿀 떎. 寃궗諛⑸쾿 紐낆묶怨 愿젴맂 援궡·쇅 愿젴 옄猷뚮 닔吏묓븯怨 遺꾩꽍븯뿬 寃궗빆紐⑸퀎 떊 遺꾨쪟븞쓣 쟻슜븿쑝濡쒖뜥 젙솗븳 룞猷 吏묐떒 꽕젙怨 뜲씠꽣 삤遺꾨쪟 諛 늻씫 諛⑹瑜 넻빐 떊猶고븷 닔 엳뒗 떊鍮숇룄議곗궗 寃곌낵瑜 젣怨듯븷 닔 엳寃 릺뿀떎.

씪諛섑솕븰寃궗 봽濡쒓렇옩뿉꽌뒗 1,000媛 씠긽쓽 湲곌씠 李몄뿬븯뒗 寃궗빆紐⑹ alanine aminotransferase (ALT), albumin, alkaline phosphatase, aspartate aminotransferase (AST), total bilirubin, chloride, total cholesterol, creatinine, gamma-glutamyl transferase, glucose, high-density lipoprotein (HDL) cholesterol, potassium, total protein, sodium, triglyceride, urea nitrogen怨 uric acid 벑씠뿀怨 1쉶李⑥ 2쉶李⑥뿉 鍮꾪빐 3쉶李⑥ 4쉶李⑥쓽 李멸湲곌 닔媛 利앷븯떎(Table 3). 슂솕븰寃궗 봽濡쒓렇옩뿉꽌뒗 깉濡 異붽맂 寃궗빆紐⑹씤 슂 hCG 젙꽦寃궗뿉 李몄뿬븯뒗 湲곌씠 媛옣 留롮븯怨 creatinine寃궗媛 뮘瑜 씠뿀떎(Table 4).

Table 3 . Number of laboratories that participated in each test of general chemistry in 2018.

TestTrials

1st2nd3rd4th
Alanine aminotransferase1,5681,6391,6761,660
Albumin1,4431,5121,5481,534
Alkaline phosphatase1,3851,4511,4791,467
Amylase800825820814
Aspartate aminotransferase1,5671,6381,6751,659
Bilirubin, direct782813813809
Bilirubin, total1,4561,5211,5571,543
Calcium698724736734
Chloride9911,0341,0511,046
Cholesterol, total1,5571,6261,6621,646
Creatine kinase652667676673
Creatinine1,5201,5951,6401,628
Gamma-glutamyl transpeptidase1,5201,5881,6221,608
Glucose1,5431,6141,6511,635
High density lipoprotein cholesterol1,4431,5011,5331,519
Iron403416421419
Lactate dehydrogenase871899916909
Lipase392399408403
Low density lipoprotein cholesterol880911920916
Magnesium280283290290
Osmolality146151151149
Phosphorus649676693687
Potassium1,0041,0481,0641,060
Protein, total1,4291,4941,5291,516
Sodium1,0041,0481,0641,060
Total CO2201209216214
Total iron-binding capacity367376382381
Triglyceride1,5151,5871,6171,601
Urea nitrogen1,4991,5701,6021,591
Uric acid1,1851,2421,2621,254
Estimated glomerular filtration rate, adult279287295293
Estimated glomerular filtration rate, child180184189193

Table 4 . Number of laboratories that participated in each test of urine chemistry in 2018.

TestTrials

1st2nd
Albumin166172
Calcium151155
Chloride177183
Creatinine206209
Glucose135137
Magnesium109108
Phosphorus138139
Potassium178184
Protein173177
Sodium180186
Urea nitrogen152156
Uric acid145146
Urine human chorionic gonadotropin (qualitative)210215

씪諛섑솕븰寃궗 봽濡쒓렇옩뿉꽌 蹂룞怨꾩닔뒗 媛 寃궗빆紐⑸퀎 쉶李⑤퀎濡 긽쟻쑝濡 젙룄愿由щЪ吏덉쓽 냽룄媛 궙쓣닔濡 넂 寃쏀뼢쓣 蹂댁떎(Table 5). 遺遺 10% 씠궡쓽 蹂룞怨꾩닔瑜 蹂댁吏留 alkaline phosphatase, amylase, direct bilirubin, lactate dehydrogenase (LDH), lipase, HDL cholesterol, low-density lipoprotein cholesterol怨 triglyceride 벑쓽 씪遺 諛⑸쾿뿉꽌 10% 씠긽쓽 넂 蹂룞怨꾩닔瑜 蹂댁떎. 臾쇰줎 룞씪븳 寃궗踰뺤쓣 궗슜븯뒗 洹몃9 궡뿉꽌뒗 鍮꾧탳쟻 옉 蹂룞怨꾩닔瑜 蹂댁쑝굹 alkaline phosphatase LDH뒗 寃궗踰 媛꾩뿉 寃곌낵쓽 李⑥씠媛 쑀쓽븯寃 겮쑝濡쒖뜥 蹂룞怨꾩닔룄 긽쟻쑝濡 겙 寃껋쑝濡 愿李곕릺뿀떎(Table 5). 슂솕븰寃궗 봽濡쒓렇옩뿉꽌 媛 寃궗빆紐 蹂 蹂룞怨꾩닔뒗 遺遺 10% 씠궡쓽 媛믪쓣 蹂댁쑝굹 albumin怨 protein 긽쟻쑝濡 넂 蹂룞怨꾩닔瑜 蹂댁떎(Table 6). 蹂 룞怨꾩닔뒗 媛곴컖 湲곌쓽 긽쟻 쐞移섎 굹궡뒗 SDI룄 愿젴 릺誘濡 蹂룞怨꾩닔媛 겙 寃쎌슦 SDI뒗 긽쟻쑝濡 옉븘吏 닔 엳쑝誘濡 寃곌낵빐꽍 떆 怨좊젮릺뼱빞 븳떎.

Table 5 . Peer-group coefficients of variation (%) for the tests and trials of general chemistry in 2018.

TestTrials

CC-18-01CC-18-02CC-18-03CC-18-04CC-18-05CC-18-06CC-18-07CC-18-08CC-18-09CC-18-10CC-18-11CC-18-12
Alanine transaminase7.49.26.17.59.26.56.65.85.85.87.36.0
Albumin5.24.45.23.64.35.14.85.45.45.64.95.5
Alkaline phosphatase43.640.637.144.841.037.444.136.838.235.844.936.0
Amylase15.915.018.315.414.418.712.718.918.817.912.918.6
Aspartate aminotransferase6.78.55.36.38.15.05.14.14.34.35.04.3
Bilirubin, direct17.214.713.914.318.012.220.717.418.719.418.615.8
Bilirubin, total12.08.96.110.58.25.99.46.06.36.310.16.5
Calcium3.12.72.33.13.02.33.33.02.92.94.42.7
Chloride3.03.02.43.13.32.32.93.03.23.03.32.8
Cholesterol, total3.02.93.13.42.73.13.05.05.14.83.14.7
Creatine kinase5.25.55.14.94.84.93.64.44.34.53.54.6
Creatinine9.48.15.58.57.65.411.77.67.77.213.47.3
Gamma-glutamyl transpeptidase6.36.25.86.25.65.47.67.77.57.87.87.4
Glucose3.33.33.23.63.43.04.03.13.02.74.13.0
High density lipoprotein cholesterol8.311.311.27.610.211.811.112.613.814.112.612.8
Iron3.53.83.53.43.53.23.44.13.83.63.13.8
Lactate dehydrogenase37.638.439.137.638.439.237.939.840.140.437.540.6
Lipase9.212.318.010.213.717.98.813.914.014.410.214.1
Low density lipoprotein cholesterol15.713.220.814.312.721.87.37.86.310.49.05.9
Magnesium3.55.42.90.03.12.13.83.23.13.95.53.2
Osmolality1.21.21.21.01.10.91.31.21.21.31.31.3
Phosphorus4.93.23.03.32.92.92.42.62.32.52.32.3
Potassium2.91.92.33.01.92.41.92.32.32.31.92.2
Protein, total2.12.83.63.22.83.93.33.84.03.83.43.7
Sodium1.91.21.41.91.21.31.11.21.31.31.21.4
Total CO29.27.85.28.88.26.86.26.55.75.05.15.7
Total iron-binding capacity3.84.03.33.73.73.23.22.93.43.23.33.5
Triglyceride33.419.446.833.120.346.34.05.75.55.34.05.5
Urea nitrogen4.04.04.15.14.04.34.73.94.94.25.24.3
Uric acid6.94.03.85.83.73.83.43.63.33.64.23.5
Estimated glomerular filtration rate, adultNA10.55.812.310.2NA10.0NA6.56.5NA0.0
Estimated glomerular filtration rate, child42.6NANANANA38.4NA56.1NANA44.7NA

Abbreviation: NA, not applicable..


Table 6 . Peer-group coefficients of variation (%) for the tests and trials of urine chemistry in 2018.

TestTrials

CUC-18-01CUC-18-02CUC-18-03CUC-18-04CUC-18-05CUC-18-06
Albumin30.019.019.414.220.332.5
Calcium4.02.72.34.32.63.4
Chloride8.82.52.59.02.48.7
Creatinine5.54.94.85.24.95.1
Glucose2.22.22.23.32.61.3
Magnesium3.02.83.53.33.63.6
Phosphorus2.52.62.92.62.82.8
Potassium2.13.13.41.83.61.9
Protein11.09.08.69.99.010.5
Sodium2.81.21.12.21.12.3
Urea nitrogen2.92.82.33.33.13.2
Uric acid4.33.53.64.63.74.5

씪諛섑솕븰寃궗뿉 엳뼱꽌 븳 媛吏 寃궗諛⑸쾿씠 쟾泥댁쓽 80%瑜 꽆뒗 寃궗濡쒕뒗 albumin쓽 dye binding bromocresol green踰, ALT쓽 LDH without pyridoxal-5-phosphate (P5P)踰, AST쓽 malate dehydrogenase without P5P踰, total cholesterol 쓽 cholesterol esterase踰, gamma-glutamyl transpeptidase 쓽 gamma-glutamyl-carboxy-nitroanilide踰, magnesium쓽 colorimetry-xylidyl blue踰, osmolality쓽 freezing point depression osmometer踰, total protein쓽 biuret踰, total CO2쓽 phosphoenolpyruvate carboxylase踰, urea nitrogen 쓽 urease with glutamate dehydrogenase (GLDH)踰뺢낵 uric acid쓽 uricase踰뺤씠 엳뿀떎(Table 7).

Table 7 . Distribution of analytical methods (principle) and coefficients of variation (%) for the principles of general chemistry in 2018.

Test/methodTrials

1st2nd3rd4th




Lab*CC-18-01CC-18-02CC-18-03LabCC-18-04CC-18-05CC-18-06LabCC-18-07CC-18-08CC-18-09LabCC-18-10CC-18-11CC-18-12
Alanine aminotransferase1,5687.49.26.11,6397.59.26.51,6766.65.85.81,6605.87.36.0
 Dry chemistry1111.116.63.41212.815.02.2103.63.23.2103.428.82.4
 LDH with P5P1316.616.63.31413.712.31.5157.02.82.0140.513.63.6
 LDH without P5P1,4617.49.06.01,5576.99.26.31,6166.65.75.71,6015.77.25.9
 Other method837.611.38.2568.07.88.3358.07.68.3357.97.47.7
Albumin1,4435.24.45.21,5123.64.35.11,5484.85.45.41,5345.64.95.5
 Dye binding-BCG1,3805.14.35.11,4633.64.35.11,5144.85.45.31,4995.64.95.5
 Dye binding-BCP74.84.26.075.84.75.984.42.95.585.64.26.2
 Other method566.44.85.8425.24.13.0265.02.52.9274.75.15.8
Alkaline phosphatase1,38543.640.637.11,45144.841.037.41,47944.136.838.21,46735.844.936.0
 Other method7337.035.932.54839.637.233.32645.036.937.52619.441.419.1
 PNPP, AMP buffer78013.214.716.283013.214.516.085613.716.316.884715.812.615.9
 PNPP, DEA buffer14714.915.512.915411.511.811.516410.39.79.816011.512.711.0
 PNPP, EAE buffer3854.03.93.54194.53.93.64335.74.75.24344.35.34.8
Amylase80015.915.018.382515.414.418.782012.718.918.881417.912.918.6
 Dry chemistry85.04.12.2811.94.45.373.42.61.273.38.53.3
 Hydrolysis of 2-chloro-4-nitrophenylazido-deoxy-maltopentaoside62.81.52.1416.918.516.950.60.21.041.28.32.1
 Hydrolysis of 2-chloro-4-nitrophenyl-galactopyranosylmaltoside941.62.01.41011.91.81.71062.31.41.31031.82.11.6
 Hydrolysis of 2-chloro-4-nitrophenyl-α-D-maltotrioside1983.23.42.92055.13.02.42122.82.31.92152.93.23.1
 Hydrolysis of 4,6-ethylidene-4-nitrophenyl-maltoheptaose3183.64.64.13424.14.73.73454.33.63.83423.94.33.6
 Hydrolysis of 4-nitrophenylbenzyl-α-maltopentaose13015.715.417.013115.914.818.613412.818.418.213118.413.118.4
 Other method4615.716.217.53416.213.819.91115.219.219.21219.813.120.5
Aspartate aminotransferase1,5676.78.55.31,6386.38.15.01,6755.14.14.31,6594.35.04.3
 Dry chemistry1112.813.13.8129.75.35.6100.00.61.3102.01.72.2
 MDH with P5P1322.527.79.61423.625.910.2154.13.85.7147.45.44.9
 MDH without P5P1,4646.68.55.11,5616.38.04.91,6185.14.14.11,6034.24.94.3
 Other method798.09.28.2517.79.56.4325.97.06.5327.47.26.5
Bilirubin, direct78217.214.713.981314.318.012.281320.717.418.780919.418.615.8
 Copper ion oxidation3815.911.59.6459.814.513.1482.26.49.64710.61.28.6
 Diazonium salt with blank2968.76.212.43146.78.011.532522.65.25.33255.718.85.4
 Diazo-sulfanilic acid with blank3043.943.428.94635.628.027.94835.034.134.14727.632.726.8
 Diazo-sulfanilic acid without blank1536.953.430.11638.141.923.41438.625.027.01529.034.827.1
 Enzymatic oxidation59.57.83.759.15.68.3622.15.15.4622.022.321.0
 Other method7430.020.825.14621.322.421.62228.717.415.12221.021.629.1
 Vanadate oxidation3243.99.76.334111.09.29.035014.212.112.03479.711.913.7
Bilirubin, total1,45612.08.96.11,52110.58.25.91,5579.46.06.31,5436.310.16.5
 Copper ion oxidation667.74.94.1734.65.04.7856.44.44.1865.16.05.3
 Diazo-caffeine, sodium benzoate with blank716.815.49.2717.018.810.587.910.310.487.27.512.0
 Diazo-dimethyl sulfoxide with blank12514.013.06.613514.013.57.21288.86.27.01236.56.76.7
 Diazo-dimethyl sulfoxide without blank8517.016.29.39713.916.86.710713.15.55.71085.814.75.9
 Diazo-dyphylline with blank1218.413.34.61214.29.35.91014.55.94.5108.87.42.8
 Diazonium salt-surfactant with blank45213.610.05.647612.09.75.148911.46.15.74856.310.66.7
 Diazonium salt-surfactant without blank379.25.711.6387.810.19.74017.412.312.33910.912.810.7
 Enzymatic oxidation246.35.64.1274.44.35.1246.77.37.4246.17.75.5
 Other method7215.512.58.65411.612.37.6399.74.65.5396.510.66.2
 Vanadate oxidation5763.15.24.66022.75.34.36262.84.34.36204.56.14.2
Calcium6983.12.72.37243.13.02.37363.33.02.97342.94.42.7
 Colorimetry arsenazo III1324.02.83.61444.33.63.91523.73.13.31553.72.73.5
 Colorimetry_methylxylenol blue203.02.43.6232.62.62.7231.51.31.1221.61.61.9
 Colorimetry_OCPC4082.92.51.84223.02.12.24273.02.92.64222.63.62.8
 NM-BAPTA1212.02.11.61261.81.71.31301.61.51.61311.41.71.6
 Other method163.93.93.384.33.22.245.63.92.642.64.02.2
Chloride9913.03.02.41,0343.13.32.31,0512.93.03.21,0463.03.32.8
 ISE, diluted5393.02.41.85572.92.61.65672.32.12.05692.53.62.5
 ISE, undiluted4132.02.22.14422.51.91.94522.42.63.24482.63.12.8
 Other method393.42.21.9352.12.62.7323.35.05.3292.81.52.8
Cholesterol, total1,5573.02.93.11,6263.42.73.11,6623.05.05.11,6464.83.14.7
 Cholesterol esterase1,4813.02.93.11,5743.32.73.11,6293.05.05.11,6144.83.14.7
 Other method763.33.32.9523.33.03.4334.04.55.8325.93.44.1
Creatine kinase6525.25.55.16674.94.84.96763.64.44.36734.53.54.6
 Creatine phosphate to creatine2013.84.52.92113.73.33.02173.52.42.82142.53.02.8
 Creatine phosphate to creatine with activator4115.55.75.64285.25.05.54373.55.14.84395.13.65.1
 Dry chemistry61.76.34.066.46.55.468.29.18.964.57.78.1
 Other method347.06.35.1226.06.46.7164.03.94.4143.66.54.2
Creatinine1,5209.48.15.51,5958.57.65.41,64011.77.67.71,6287.213.47.3
 Enzymatic method664.15.55.6746.96.23.87813.13.64.5764.731.75.7
 Kinetic Jaffe with compensation33310.86.63.835710.66.23.837110.86.87.53686.011.96.5
 Kinetic Jaffe without compensation8127.66.97.08676.66.66.69057.37.07.38956.511.46.0
 Other method6513.213.812.14713.512.311.02811.210.310.63112.39.010.3
 Rate blanked compensated kinetic Jaffe method2444.24.13.42504.14.22.82584.53.43.52583.16.13.2
Gamma-glutamyl transpeptidase1,5206.36.25.81,5886.25.65.41,6227.67.77.51,6087.87.87.4
 Gamma-glutamyl-carboxy-nitroanilide1,4186.36.15.71,5116.25.65.41,5637.67.77.81,5497.77.67.4
 Gamma-glutamyl-p-nitroanilide149.18.58.81710.17.59.81612.011.812.6168.99.410.4
 G-glutamyl-p-nitroanilide (dry chemistry)122.421.66.51221.43.611.7104.31.71.6102.46.82.3
 Other method766.77.36.7487.06.04.7338.57.06.6339.511.39.0
Glucose1,5433.33.33.21,6143.63.43.01,6514.03.13.01,6352.74.13.0
 Glucose oxidase3845.45.04.14165.15.04.24414.44.04.24313.74.34.0
 Hexokinase1,0843.02.82.71,1472.82.72.61,1793.62.62.71,1732.43.52.4
 Other method755.24.74.1514.84.13.0316.35.64.9315.25.55.5
High density lipoprotein cholesterol1,4438.311.311.21,5017.610.211.81,53311.112.613.81,51914.112.612.8
 Enzymatic with detergent5194.76.36.05524.05.86.65788.710.09.95788.78.88.5
 Enzymatic with immunoinhibition2043.84.04.82184.44.56.62213.63.43.52223.54.03.3
 Enzymatic with others1899.39.915.21978.89.115.521011.313.313.120313.511.412.5
 Enzymatic with polyanion precipitation16715.914.419.018117.315.619.018517.19.59.317910.813.29.3
 Enzymatic with polyethylene glycol2896.25.39.52999.17.49.83105.15.56.53079.87.46.2
 Other method7410.812.613.55311.012.211.0289.213.913.3299.215.112.3
Iron4033.53.83.54163.43.53.24213.44.13.84193.63.13.8
 Bathophenanthroline without deproteinization1371.92.01.61422.12.21.61451.42.52.31432.11.42.3
 Ferene with deproteinization36.77.16.5310.010.20.032.58.13.832.10.40.8
 Ferrozine without deproteinization1372.32.22.11422.33.12.41462.03.62.41462.71.83.0
 Nitroso-PSAP without deproteinization341.91.91.8422.51.91.4431.73.12.7432.91.73.2
 Pyridyl AZO dye ascorbate without deproteinization219.013.59.3317.611.510.928.728.32.525.00.80.0
 Tripyridyltriazine without deproteinization772.11.61.6802.31.91.4811.42.82.6802.10.92.3
Lactate dehydrogenase87137.638.439.189937.638.439.291637.939.840.190940.437.540.6
 Lactate to pyruvate4434.74.74.44604.64.54.14854.95.25.14804.94.84.8
 Other method3934.034.035.22737.335.934.31132.331.932.11234.031.133.2
 Pyruvate to lactate3827.57.89.34067.68.29.54147.17.27.44117.27.17.3
 Pyruvate to lactate (dry chemistry)753.453.253.169.09.19.261.53.01.964.52.55.1
Lipase3929.212.318.039910.213.717.94088.813.914.040314.410.214.1
 Hydrolysis of 1,2-diglyceride with quinone dye1007.79.313.31047.510.88.41034.25.06.1822.83.82.3
 Hydrolysis of 1,2-O-dilauryl-rac-glycero-3-glutaric acid-(6’-methylresorufin) ester2595.44.96.92736.35.97.32858.813.213.430214.98.414.7
 Hydrolysis of 1-oleoyl-2,3-diacetyl glycerol92.14.15.994.04.25.982.72.42.882.64.32.0
 Other method2421.321.020.51322.015.415.6128.712.012.6115.114.19.8
Low-density lipoprotein cholesterol88015.713.220.891114.312.721.89207.37.86.391610.49.05.9
 Enzymatic with detergent58716.112.522.461814.912.423.96427.47.36.464010.99.85.8
 Enzymatic with others22913.211.015.323311.710.815.92307.37.26.92297.16.07.5
 Enzymatic with polyethylene glycol329.79.721.2347.44.119.1346.48.29.9337.75.65.5
 Other method3214.313.621.22614.415.021.4146.38.57.51412.48.49.8
Magnesium2803.55.42.92830.03.12.12903.83.23.12903.95.53.2
 Colorimetry_Xylidyl blue2683.45.32.92740.03.12.22863.83.23.12863.95.43.2
 Dry chemistry46.15.45.332.94.41.328.31.71.623.211.53.1
Osmolality1461.21.21.21511.01.10.91511.31.21.21491.31.31.3
 Freezing point depression osmometer1281.31.11.31341.11.20.91381.21.01.21381.41.31.3
 Other method181.21.41.2170.80.61.8131.31.01.1111.61.82.0
Phosphorus6494.93.23.06763.32.92.96932.42.62.36872.52.32.3
 Enzymatic52.72.22.2411.610.79.772.21.91.773.41.82.7
 Molybden blue colorimetry1393.31.82.31470.01.92.21572.42.21.91552.02.32.1
 Other method184.47.57.91111.39.37.632.63.33.244.46.97.4
 Phosphomolybdate4873.43.12.55143.31.92.25262.42.22.35212.22.32.2
Potassium1,0042.91.92.31,0483.01.92.41,0641.92.32.31,0602.31.92.2
 ISE, diluted5412.51.81.35592.41.71.25691.81.41.65711.51.81.4
 ISE, undiluted4243.02.82.64543.02.12.84632.11.62.54601.52.11.5
 Other method395.73.53.8353.12.43.4322.54.23.9292.62.13.5
Protein, total1,4292.12.83.61,4943.22.83.91,5293.33.84.01,5163.83.43.7
 Biuret method1,3702.12.83.51,4513.22.83.91,5023.33.84.01,4873.83.33.7
 Other method595.55.26.3433.73.84.7274.55.84.7295.14.65.2
Sodium1,0041.91.21.41,0481.91.21.31,0641.11.21.31,0601.31.21.4
 ISE, diluted5041.21.11.05261.21.00.95370.71.11.15391.21.11.2
 ISE, undiluted4611.81.61.44871.81.61.54941.21.41.64911.51.41.7
 Other method391.91.42.2351.91.41.9331.92.11.8301.81.52.0
Total CO22019.27.85.22098.88.26.82166.26.55.72145.05.15.7
 Other method108.65.39.575.45.97.7612.110.24.355.07.14.7
 Phosphoenolpyruvate carboxylase1919.27.65.72029.28.46.62106.26.45.62094.94.65.7
Total iron-binding capacity3673.84.03.33763.73.73.23823.22.93.43813.23.33.5
 Bathophenanthroline1233.32.72.31312.42.22.11361.62.52.51342.12.02.9
 Chromazural B182.32.04.5193.22.83.2173.62.82.9173.44.33.0
 Ferrozine1053.53.53.91084.43.53.11122.43.03.41143.32.83.2
 Nitroso-PSAP972.32.22.11043.12.32.21102.52.42.71082.22.92.1
 Other method244.26.85.6142.42.17.378.511.010.0812.14.712.0
Triglyceride1,51533.419.446.81,58733.120.346.31,6174.05.75.51,6015.34.05.5
 Enzymatic with free glycerol elimination4885.75.37.15185.56.07.05262.83.33.25273.12.82.6
 Enzymatic without free glycerol elimination9524.74.54.31,0194.74.14.01,0614.86.76.61,0456.44.56.3
 Other method7535.719.746.15033.220.344.1306.06.26.5295.74.43.3
Urea nitrogen1,4994.04.04.11,5705.14.04.31,6024.73.94.91,5914.25.24.3
 Other method697.75.03.6485.36.16.1296.89.47.22910.08.97.9
 Urease with colorimetry187.94.45.6199.67.76.9186.08.99.1179.56.18.7
 Urease with GLDH1,4114.03.84.11,5025.04.04.21,5544.73.84.91,5444.25.14.3
Uric acid1,1856.94.03.81,2425.83.73.81,2623.43.63.31,2543.64.23.5
 Other method487.26.25.2336.15.14.5208.65.97.0205.17.84.5
 Uricase1,1316.94.03.81,2035.93.63.81,2363.33.63.31,2283.44.23.5
 Uricase (dry chemistry)61.71.71.963.41.81.761.11.31.260.62.52.0
Estimated glomerular filtration rate, adult27910.55.828712.310.229510.06.52936.50.0
 Others1915.10.01710.615.71816.621.31717.228.2
 CKD-EPI488.75.1518.310.4538.96.5535.80.0
 Cockcroft-Gault108.97.0118.111.9811.325.198.88.5
 MDRD 4 variable (IDMS-traceable)1329.25.413511.610.31429.96.01410.00.0
 MDRD 4 variable (non IDMS-traceable)698.95.27210.28.57111.57.3719.78.9
 MDRD 6 variable11318.54.920.00.0
Estimated glomerular filtration rate, child4542.64538.44356.14444.7
 Others1870.31653.01663.91561.9
 Cockcroft-Gault512.850.04134.448.9
 Schwartz1615.51617.01519.11720.4
 Updated bedside Schwartz61.384.687.288.0

Abbreviations: LDH, lactate dehydrogenase; P5P, pyridoxal-5-phosphate; BCG, bromocresol green; BCP, bromocresol purple; PNPP, para nitrophenylphosphate; AMP, 2-amino-2-methyl-1-propanol; DEA, diethanolamine; EAE, 2-ethylaminoethanol; MDH, malate dehydrogenase; OCPC, o-creolphthalein complexone; NM-BAPTA, 5-nitro-5’-methyl-BAPTA; ISE, ion-selective electrodes; Nitroso-PSAP, 2-nitroso-5-(N-propyl-N-sulfopropylamino)-phenol; GLDH, glutamate dehydrogenase; CKD-EPI, chronic kidney disease epidemiology collaboration; MDRD, modification of diet in renal disease; IDMS, isotope-dilution mass spectrometry..

*Number of laboratories that participated in the Korean External Quality Assessment Service 2018.


슂솕븰寃궗빆紐 以 albumin怨 protein 痢≪젙踰뺤쓽 遺꾪룷媛 씪諛섑솕븰寃궗 李⑥씠媛 엳뿀떎. Albumin쓽 痢≪젙踰뺤쑝濡쒕뒗 immunoturbidimetry踰뺤씠 二쇰줈 씠슜릺뿀怨 protein쓽 痢≪젙 踰뺤쑝濡 dye binding using pyrogallol red踰뺢낵 turbidimetry using benzethonium chloride踰뺤씠 씠슜릺뿀떎(Table 8).

Table 8 . Distribution of analytical methods (principle) and coefficients of variation (%) for the principles of urine chemistry in 2018.

Test/methodTrials

1st2nd


Lab*CUC-18-01CUC-18-02CUC-18-03Lab*CUC-18-04CUC-18-05CUC-18-06
Albumin16630.019.019.417214.220.332.5
 Dye binding-BCG215.712.713.2233.926.344.7
 Immunoturbidimetry15529.717.718.016013.918.630.0
Calcium1514.02.72.31554.32.63.4
 Arsenazo III dye194.13.02.7222.34.03.4
 Cresolphthalein complexone793.83.02.7773.92.43.3
 MXB method (methylxylenol blue)42.01.11.857.30.95.4
 NM-BAPTA472.11.71.8492.81.92.8
Chloride1778.82.52.51839.02.48.7
 ISE, diluted (indirect)1708.52.52.51768.62.48.5
 ISE, undiluted (direct)48.511.612.1415.415.715.2
Creatinine2065.54.94.82095.24.95.1
 Compensated kinetic Jaffe method502.02.72.5501.82.32.3
 Enzymatic method102.43.13.5102.33.13.3
 kinetic Jaffe method565.15.24.5574.24.64.1
 Rate blanked compensated kinetic Jaffe method893.73.73.4913.83.53.6
Glucose1352.22.22.21373.32.61.3
 Hexokinase1342.22.22.21363.32.72.6
Magnesium1093.02.83.51083.33.63.6
 Chlorophosphonazo III213.01.20.8
 Colorimetrc test-Xylidyl blue113.51.11.7114.33.75.8
 Colorimetric (Dye-Xylidyl blue/magon)953.02.93.6963.13.63.5
Phosphorus1382.52.62.91392.62.82.8
 Phosphomolybdate with any reduction method32.20.91.840.42.51.2
 Phosphomolybdate, UV1352.52.62.81352.62.82.9
Potassium1782.13.13.41841.83.61.9
 ISE, diluted (indirect)1712.13.13.51771.83.71.9
 ISE, undiluted (direct)44.211.912.545.521.04.7
Protein17311.09.08.61779.99.010.5
 Biuret method514.312.19.345.67.39.2
 dye binding using pyrogallol red9713.310.39.210212.510.015.0
 turbidimetry using benzethonium chloride695.33.63.8705.33.55.1
Sodium1802.81.21.11862.21.12.3
 ISE, diluted (indirect)1722.81.21.01782.21.12.3
 ISE, undiluted (direct)53.73.34.154.32.60.0
Urea nitrogen1522.92.82.31563.33.13.2
 Enzymatic UV test (urease-GLDH)95.51.83.795.45.72.8
 Urease with GLDH (coupled enzymes)1432.82.52.31473.03.23.1
Uric acid1454.33.53.61464.63.74.5
 Uricase1434.43.53.61444.63.74.5

Abbreviations: BCG, bromocresol green; NM-BAPTA, 5-nitro-5’-methyl-BAPTA; ISE, ion-selective electrodes; UV, ultra violet; GLDH, glutamate dehydrogenase..

*Number of Laboratories participated in Korean External Quality Assessment Service 2018.


2018뀈 씪諛섑솕븰寃궗 봽濡쒓렇옩怨 슂솕븰寃궗 봽濡쒓렇옩쓽 떊鍮숇룄議곗궗 寃곌낵뿉 빐 蹂대떎 옄꽭븳 넻怨꾨텇꽍 寃곌낵뒗 븳엫긽寃궗젙룄愿由ы삊쉶 떊鍮숇룄議곗궗궗뾽 솃럹씠吏(http://eqas. keqas.org)뿉꽌 議고쉶媛 媛뒫븯떎.

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