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Clinical Chemistry 38: 1365-1370, 1992;
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Clinical Chemistry, Vol 38, 1365-1370, Copyright © 1992 by American Association for Clinical Chemistry

Testing for creatine kinase and creatine kinase-2 in Ontario: reference ranges and assay types

AR Henderson, MJ McQueen, RL Patten, S Krishnan, DE Wood and S Webb
Enzyme and Lipids Committee, Laboratory Proficiency Testing Program, Ontario, Canada.

In 1991, 246 and 136 Ontario laboratories performed total creatine kinase (CK; EC 2.7.3.2) and creatine kinase-2 (CK-2) assays, respectively. A questionnaire mailed to these laboratories requested information about the types of assay used, the origin of their reference ranges, and the source of their instruments and reagents. All laboratories used current test formulations for CK, although seven laboratories did not assay at 37 degrees C. For CK, 69% of all laboratories reported different upper reference limits for men and women (5th-95th percentiles: 160-250 and 115-215 U/L, respectively); 31% reported similar ranges for both sexes. Fifty-six percent derived their own ranges; the remainder used either kit inserts or literature references, and nearly 60% of this latter group claimed to have validated these suggested ranges before use. For 6% of all laboratories, their pediatric ranges were similar to their adult ranges. For CK-2, only 32% used their own reference range; the remainder used kit inserts or literature references, but only 49% of this group validated these ranges before use. Reference limits (5th- 95th percentiles) for CK-2 were as follows: activity 6-24 U/L; fraction of CK, 0.022-0.06; and, for mass assays, 5-10 micrograms/L and relative index 0.015-0.04.


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A. R. Henderson, S. Krishnan, S. Webb, C. M. Cheung, D. J. Nazir, and H. Richardson
Proficiency testing of creatine kinase and creatine kinase-2: the experience of the Ontario Laboratory Proficiency Testing Program
Clin. Chem., January 1, 1998; 44(1): 124 - 133.
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Copyright © 1992 by the American Association for Clinical Chemistry.