Vol. 8 No. 1 (2026): May 2026
Original Articles

Optimization of Variations in Trichloroacetic Acid Concentration in The Handling of Icteric Samples in Uric Acid Level Examination by Uricase Method

Sulthan Abyan Surya Durachman
Poltekkes Kemenkes Bandung

Published 2026-05-01

Keywords

  • Icteric,
  • Gout,
  • Pre-Analytic,
  • Trichloroacetic Acid (TCA)

How to Cite

Surya Durachman, S. A., Riyani, A., Kanto, D. A. R., & Nurhayati, D. (2026). Optimization of Variations in Trichloroacetic Acid Concentration in The Handling of Icteric Samples in Uric Acid Level Examination by Uricase Method. Jaringan Laboratorium Medis, 8(1), 49–56. https://doi.org/10.31983/jlm.v8i1.14414

Abstract

Uric acid examination of the uricase method can be disturbed due to bilirubin in icteric serum. Bilirubin absorbs light at a similar wavelength to uricase reaction products, so it can cause gout results to appear higher than they actually are. To overcome this, proper pre-analytical handLing is needed with the addition of trichloroacetic acid (TCA). The purpose of this study was to determine the difference in uric acid levels before and after the addition of TCA to icteric serum and to determine the optimal concentration of TCA to reduce bilirubin disorders in uric acid examination. This research method uses a quasi-experiment using pooled sera that were recognized using catfish bile, with bilirubin levels of 2.13; 2.83; and 3.96 mg/dL. Each sample was treated with TCA at concentrations of 4%, 5%, and 6%. Uric acid levels were checked using the uricase method and data were analyzed using ANOVA and Post Hoc tests. The results showed a decrease in uric acid levels as TCA concentrations increased. The concentration of 6% TCA provided the most significant reduction, but the 5% TCA at bilirubin level of 2.83 mg/dL showed no significant difference compared to normal pooled sera (p > 0.05), suggesting that 5% TCA was the optimal concentration in the handLing of icteric samples on uric acid examination.

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References

  1. BIOLABO. (2022). Uric Acid Uricase method.
  2. Christopher-John, L., & Andrew, C. (2016). Serum Indices: Managing Assay Interference. Sage Journals, 53(5), 527–538.
  3. Contois, J. H., & Nguyen, R. A. (2012). A Need for Increased Understanding and Testing. Germany: Diagnostic System.
  4. Ermiyanti, Arniat, C., & Rahmi, N. (2022). Perbandingan Kadar Asam Urat Antara Metode POCT Dan Enzimatik. Jurnal Kesehatan Medika Saintika, 13(2), 98–106.
  5. Isselbacher, K. J., Braunwald, E., Wilson, J. D., Martin, J. B., Fauci, A. S., & Kasper, D. L. (1995). Harrison prinsip-prinsip ilmu penyakit dalam (13th ed., Vol. 1). Penerbit Buku Kedokteran EGC.
  6. Lolekha, P. H., Jaruthunyaluck, S., & Srisawasdi, P. (2001). Deproteinization of serum: Another best approach to eliminate all forms of bilirubin interference on serum creatinine by the kinetic Jaffe reaction. Journal of Clinical Laboratory Analysis, 15(3), 116–121. https://doi.org/10.1002/jcla.1013
  7. Mengko, R. (2013). Instrumen Laboratorium Klinik. ITB.
  8. Mustakin, F., & Tahir, M. M. (2019). Analisis Kandungan Glikogen pada Hati, Otot, dan Otak Hewan (Analysis Of Glicogen Content On Heart, Muscle, And Animal Brain). 2(2). https://doi.org/10.20956/canrea.v2i2.xxx
  9. Nicolay, A., Lorec, A., Gomez, G., & Portugal, H. (2018). Icteric human samples: Icterus index and method of estimating an interference‐free value for 16 biochemical analyses. Journal of Clinical Laboratory Analysis, 32(2). https://doi.org/10.1002/jcla.22229
  10. Parmar, V., Sanghani, H., & Khubchandani, A. (2020). Use of deproteinizer to eliminate interference of high bilirubin on measurement of serum creatinine by the kinetic jaffe reaction. International Journal of Clinical Biochemistry and Research, 5(2), 226–229. https://doi.org/10.18231/2394-6377.2018.0047
  11. Prasad, P., Kumar, R., & Kumari, R. (2019). Pre-analytical errors in clinical chemistry laboratory of a tertiary care hospital. International Journal of Research in Medical Sciences, 7(10), 3815. https://doi.org/10.18203/2320-6012.ijrms20194315
  12. Rajalingam, D., Loftis, C., Xu, J. J., & Kumar, T. K. S. (2009). Trichloroacetic acid-induced protein precipitation involves the reversible association of a stable partially structured intermediate. Protein Science : A Publication of the Protein Society, 18(5), 980–993. https://doi.org/10.1002/pro.108
  13. Siregar, Tuntun, M., Wulan, W. S., Setiawan, D., & Nuryati, A. (2018). Kendali Mutu. Pusat Pendidikan Sumber Daya Manusia Kesehatan.
  14. Sukorini, U., Nugroho, D. K., & Rizki, M. (2010). Pemantapan Mutu Internal Laboratorium Klinik. Alfamedia.
  15. Suprayogi. (2017). Spektrofotometri. MRK Diagnostics.
  16. Urbaningrum, V., Vivin, Karlina Hale, L., Setiawati, L., Maldini, Lillah, L., Akhir, M. H., & Salpa. (2023). Pemeriksaan Kadar Asam Urat di Dusun III Desa Daenggune Kec.Kinovaro. EJOIN : JURNAL PENGABDIAN MASYARAKAT, 1(4), 300–303.
  17. Veena, A., Kulkarni, R., Cherian, S., Pillai, R., & Shivali, M. (2009). Hyperbilirubinemia in normal healthy donors. Asian Journal of Transfusion Science, 3(2), 70–72.
  18. Weber, J., & Van Zanten, A. (1991). InIterferences in Current Methods for Measurements of Creatinine. Clinical Chemistry, 37(5), 695–700.
  19. Widjaya, A. (2016). Pemeriksaan Kadar Kolesterol Total Pada Serum Ikterik Yang Diolah Dengan Variasi Konsentrasi Asam Trikloroasetat. Sekolah Tinggi Analis Bakti Asih Bandung.