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1.
The prevalence of microalbuminuria was assessed in 174 albustix negative hypertensive patients by estimating albumin in the morning random urine samples by immunoturbidimetric method within four hours of voiding of urine. The urine samples were not stored and collected without any preservatives. The urinary albumin was calculated in terms of ratio with respect to urinary creatinine and expressed as albumin creatinine ratio (mg/g). Out of 174 albustix negative hypertensives, 58 (33.3%) patients were found to have microalbuminuria. The prevalence of microalbuminuria in males and females was found to be 34% and 30.7% respectively. No correlation was found between the Body Mass Index (BMI) and albumin excretion (r2 = 0.0271) and between duration of hypertension and urinary albumin excretion (r2 = 0.0042). Prevalence of microalbuminuria in nonsmokers and non-alcoholic hypertensives was 20%. The prevalence in alcoholics, smokers and both smokers and alcoholics was found to be 35%, 42% and 41% respectively. The high prevalence of microalbuminuria than the various reported studies on the subject demands establishment of a screening programme for microalbuminuria, implementation of specific intervention methods and education of hypertensive patients about the consequences of smoking and alcohol on possible involvement of renal system.  相似文献   

2.
Twenty-four hour urinary albumin excretion (UAE) is considered as gold standard method for albuminuria measurement, but collection of 24-h urine is inconvenient. The aim of present study was to evaluate whether albumin: creatinine ratio (ACR) and urinary albumin concentration (UAC) in different spot urine samples correlate or not with 24-h UAE for screening of microalbuminuria in type 2 diabetic patients. We collected first morning void (FMV), random urine sample (RUS) and 24-h urine, separately on consecutive days from 104 type 2 diabetic patients. ACR and UAC in each spot urine sample compared with 24-h UAE with regard to Pearson correlation coefficient. Pearson’s correlation of albumin: creatinine ratio (ACR) with 24-h UAE was (r = 0.802 and 0.623) in first morning void (FMV) and random urine sample (RUS), respectively. Pearson’s correlation coefficient of urinary albumin concentration (UAC) compared with 24-h UAE was (r = 0.943 and 0.920), in FMV and RUS, respectively, P < 0.01. Results revealed that values in first morning void (FMV) were better correlated with 24-h urinary albumin excretion (UAE), than the values in random urine sample (RUS). We conclude that the first morning void (FMV) may be able to replace 24-h urine collection, preferably urinary albumin concentration (UAC) in the initial screening of microalbuminuria in diabetic patients.  相似文献   

3.
Albumin and enzymes-N-acetyl-beta-glucosaminidase (NAG) and gamma glutamyl transferase (GGT) were estimated in the morning random urine samples of 196 albustix negative diabetic patients to evaluate the clinical utility of these urinary enzymes as early markers of diabetic nephropathy. Albumin was estimated by immunoturbidimetric method and enzymes by linetic essay within six hours of voiding of urine. The urinary albumin and urinary enzyme concentration was calculated in terms of ratio with respect to urinary creatinine. Correlation coefficient (r) bewween urinary albumin and urinary enzymes in normoalbuminuric, microalbuminuric and overall diabetic cases was 0.23, 0.32 and 0.40 respectively for NAG, and 0.08, 0.06 and 0.18 respectively for GGT. NAG excretion was found increased in 34%, 63.7% and 49.5% of normoalbuminuric, microalbuminuric and overall diabetic cases respectively while GGT in 6.4%, 24.5% and 15.8%. The correlation coefficient between urinary albumin and NAG in normoalbuminuric, microalbuminuric, and overall diabetic patients with increased NAG excretion was found only 0.31, 0.27 and 0.35 respectively. No correlation was found between duration of diabetes and enzyme excretion. The study suggests that urinary NAG or GGT or both together do not have any clinical significance as an early marker of diabetic nephropathy.  相似文献   

4.
IntroductionThe intraindividual variability in urinary creatinine excretion is notoriously large. The aims of this study were to investigate the variability of duplicate consecutive 24-hour urinary creatinine excretions in patients and to develop a model for the detection and correction of discrepant creatinine excretions.Materials and methodsA group of 270 patients (82 men and 188 women) were included in the study. We collected the following data: urinary 24-hour volumes (volumetric/gravimetric) and urinary creatinine concentrations (Jaffé/enzymatic) on both collection days. We performed specific calculations to detect discrepant creatinine excretions.ResultsIn 60 patients (22%) discrepant collections were found. Among the remaining 78%, 22% of the patients collected very accurately (almost identical urinary creatinine excretions). In this subgroup the volume ratios and the creatinine concentration ratios behave inversely as in a dilution curve. A theoretical model and six collection scenarios were developed to detect, interpret and correct discrepant collections. Practical examples are given to illustrate the use of the model in successful correction of creatinine and other analytes for under- or overcollection.ConclusionsWe conclude that missed or overcollected urine volumes are the largest source of variation in creatinine excretion. Discrepancies in consecutive duplicate 24-hour creatinine excretions can be detected and corrected with specific calculations by means of the presented model. The effectiveness of these corrections is demonstrated with examples from daily practice. These calculations can be easily automated.  相似文献   

5.
A randomized case control hospital based study was conducted over 12 months time on 31 asphyxiated and 31 normal newborn to see whether urinary uric acid can be used as a marker of perinatal asphyxia and can be correlated with the clinical diagnosis by Apgar score. Uric acid and creatinine were estimated in spot urine within 24 hours after birth in both cases and controls. A ratio between concentrations of uric acid to creatinine was estimated and compared between cases and controls. It was found that the ratios were significantly higher in cases than controls (3.1± 1.3 vs 0.96± 0.54; P < 0.001) and among asphyxia patients, a significant negative linear correlation was found between the uric acid to creatinine ratio and the Apgar score (r = −0.857, P < 0.001). So urinary uric acid to creatinine ratio can be used as an additional non-invasive dispace, easy and at the same time early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and severity grading of asphyxia by Apgar score.  相似文献   

6.
Given the paucity of studies conducted to know the effect of suddenness and earlier onset of endocrinological changes associated with hysterectomy, on the serum and urinary levels of calcium, magnesium and phosphate the present study was conducted to compare the levels of calcium, magnesium and phosphate in serum and urine of hysterectomised and natural menopausal south Indian women. This is a cross-sectional observational study. The study included three groups of 30 healthy premenopausal, 30 early surgical menopausal and 30 natural post menopausal women. Women suffering from any endocrine disease were excluded. Analysis was performed in serum and urine sample. The levels of calcium, magnesium and phosphate in serum and calcium/creatinine, magnesium/creatinine and phosphate/creatinine ratio were estimated in urine by spectrophotometric method. Hysterectomised women (serum calcium: 8.7 ± 0.09 mg/dl; urine calcium/creatinine: 0.16 ± 0.02) have significantly low serum calcium (p < 0.001) and high urinary calcium/creatinine (p = 0.002) ratio and post menopausal women (serum magnesium: 2.1 ± 0.03; serum phosphate: 4.4 ± 0.16; urinary calcium/creatinine: 0.17 ± 0.02; urinary magnesium/creatinine: 0.09 ± 0.01) have significantly high serum magnesium (p = 0.016), serum phosphate (p = 0.043) and high urinary calcium/creatinine (p = 0.002), magnesium/creatinine ratio (p = 0.025) compared to healthy pre menopausal women. Post menopausal women (serum calcium: 9.1 ± 0.08) have significantly high serum calcium and phosphate compared to hysterectomised women (serum phosphate: 3.93 ± 0.11). Hysterectomised women have significantly low serum calcium, oestrogen and high urinary calcium/creatinine ratio compared to healthy premenopausal women and low serum calcium and low serum phosphate compared to natural postmenopausal women. Natural postmenopausal women had low serum oestrogen and high serum magnesium, serum phosphate, urinary calcium creatinine ratio and urinary magnesium creatinine ratio compared to healthy premenopausal women.  相似文献   

7.
Metabolic abnormalities were investigated in 44 stone patients with first time (group 1) and 56 with 2 times stone formation (group 2), and in 25 normal individuals. 24hr urine was analysed spectrophotometrically for oxalate, calcium, magnesium, citrate, uric acid, phosphate and creatinine. Hypocitraturia and hyperoxaluria were the common abnormalities in the stone formers. Stone patients had significantly higher urinary oxalate, calcium and uric acid and lower phosphate than normal individuals. Citrate/calcium and magnesium/calcium ratio were significantly high in normal individuals than stone formers. Patients in group 2 excreted significantly higher urinary calcium and lower citrate that patients in group 1. Citrate/calcium ratio was higher in group 1 than group 2. Hypocitraturia, hyperoxaluria, hypercalciuria and increased citrate/calcium and magnesium/calcium ratio seem to be an essential risk factor for stone formation. Patients with recurrent stone formation could be distinguished from patients with first time stone formation on the basis of urinary calcium and citrate.  相似文献   

8.
Human urine gives evidence of the metabolism in the body and contains numerous organic acids and other compounds at a variety of concentration. The concentration of organic acids in urine varies from population to population due to genotype, food habits and other epigenetic and environmental influences. Knowledge of the reference values for urinary organic acids in a healthy pediatric population is very important for critical evaluation. This study was designed to quantify 16 organic acids in a healthy north Indian pediatric population. Early morning urine samples from healthy pediatric subjects of age 1 day to 16 years who did not have symptoms of any disease were analyzed for organic acid content. The children were not on any supplemental vitamins or drugs and were on a free and unrestricted diet. The creatinine concentration of each sample was determined before organic acid analysis. Organic acids were extracted from urine with ethyl acetate, extracted residue was air dried, converted into trimethylsilyl derivatives and analysed by gas chromatography mass spectrometry. Here we reported the age wise mean values and standard deviations for each compound, adjusted for creatinine content (mmol/mol of creatinine). We found the concentration of most of the metabolites are higher in our population in comparison to other populations. Such data may help to provide a basis for diagnosing metabolic abnormalities in patients in a specific ethnicity.  相似文献   

9.
Proteinuria in subjects with sickle cell anaemia (SCA) is an indication of an ongoing renal insufficiency and it’s prevalence varies between sexes. We evaluated sex differences in the activities of Lecithin: cholesterol acyltransferase (LCAT), Lipoprotein lipase (LPL) and the levels of lipoproteins in SCA patients with proteinuria. Fifty SCA patients (30 males aged: 26.4 ± 7.3 years and 20 females, aged 25.4 ± 2.6 years) and 50 age and sex matched control SCA patients were recruited for the study. Random urine specimens were collected and tested for the presence of albumin by urine dipstick technique. A 24 h urinary protein was quantitated using sulphosalicylic acid technique. Fasting serum total cholesterol, triglyceride, urea and creatinine were determined using enzymes catalyzed colorimetric methods. HDL cholesterol was determined in the supernatant after precipitation with manganese chloride–phosphotungstic acid solution. LCAT was measured using the Anasolv LCAT assay with proteoliposome as substrate. LPL was determined by incubating the serum in glyceryl trioleate substrate, the glycerol liberated was measured in an aliquot of the incubating mixture. In male SCA controls there was 18.2 and 6.9% increase in the activities of LPL and LCAT respectively when compared with females but in SCA patients with proteinuria there was 8.4 and 5.2% decreases in the male SCA patients compared with females. The concentration of 24 h urine protein in the SCA male subjects with proteinuria was significantly higher (0.25 g/day; P < 0.001) compared with the SCA female patients with proteinuria (0.09 g/day). There are sex differences in the activities of LCAT and LPL in SCA patients with proteinuria. Metabolism of these lipolytic enzymes may be modulated differently in SCA patients with proteinuria.  相似文献   

10.
Ten normal subjects (NS) and 28 stone formers (SF) underwent 1 and 2 gm. calcium loading test following three days of calcium restricted diet (400 mg/day). On 4th day first 24-hr. urine sample was collected. An additional 1 and 2 gm. of calcium (Calcium gluconate) was given orally on 5th and 6th day respectively and 24-hr. urine samples were collected on both the days. Before loading, all the NS had normal calcium excretion (<200 mg/day). Calcium loading caused hypercalciuria in 10% and 20% cases respectively. Among SF, 17.9% cases were already hypercalciuric and calcium loading increased it to 42.9% and 46.4% patients respectively. The results indicated that exogenous calcium had only limited capacity to increase urinary calcium and that the magnitude of rise was relatively higher in SF. The increased excretion in SF was primarily due to intestinal hyperabsorption of calcium.  相似文献   

11.

Introduction:

We hypothesized that patients are poorly informed about proper procedure for 24-hour urine specimen collection and its relevance in determination of biochemical analytes, despite availability of leaflets and webpage with instruction for collection. The aim of this survey was to question outpatients how well are they informed about procedure of 24-hour urine specimen collection.

Materials and methods:

The survey with 10 questions was done in outpatient laboratory of University Department of Chemistry, Medical School University Hospital Sestre Milosrdnice, Zagreb, Croatia. The study included 59 patients with collected 24-hour urine sample who have consented to participate in the survey.

Results:

Out of 59 participants, most of them (0.97) were older than 40 years. Internet was not recognized as a source of information (1/59). Almost one third of the patients have changed their drinking habits to collect more urine volume. Although most of the patients (0.60) were aware that the bottle of water is the best choice for the container, almost half of them were collected urine samples in the plastic soft drink bottle. Laboratory staff and physicians often have given information about proper collection procedure, but that information was insufficient.

Conclusions:

Patients are usually not aware of importance of proper preanalytical procedure for collecting urine specimen and how improper collection could affect results of requested tests. Education of outpatients, general practitioners and laboratory staff is needed in order to improve sample quality and trueness of results.  相似文献   

12.
Six consecutive day and night urine samples from 25 renal stone patients and 25 comparabe controls were collected and analysed for total mucoproteins, Tamm-Horsfall mucoprotein, & creatinine. In normal subjects the 24 hour, day and night urinary excretion of mucoprotein was 101.4±34.5, 58.2±20.1 and 40.5±19.3 mg respectively. The Tamm-Horsfall mucoprotein excretion was 43.9±18.4, 21.5±8.6 and 20.6±9.9 mg in respective samples. Stone formers excreted significantly higher amount of mucoprotein but not the Tamm-Horsfall mucoprotein. Furthermore, the diurnal variations was visible only for in case of total mucoprotein in both the groups.  相似文献   

13.
A metabolomic study for determination of certain urinary metabolomes, 1-methyladenosine (1-MA), 1-methylguanosine (1-MG), and 8-hydroxy-2′ deoxyguanosine (8-OHdG) in urine specimens of breast cancer patients. The accuracy of these metabolites and their combined score with cancer antigen 15-3 (CA15-3) was developed to improve the early detection of breast cancer. This study recruited 52 healthy individuals, 47 benign breast tumors, and 167 malignant breast tumor patients. Urine samples were handled to adjust the creatinine concentrations to 8 mg/dL (0.7 mmol/L) and analyzed using GC–MS to detect and quantify the selected urinary metabolomes in urine samples of all participants. The accuracy of individual urinary metabolomes and their combination with CA15-3 were evaluated using multivariate statistical analysis. The cutoff value of CA15-3 was 32.5 U/mL. Cutoff values of 1-MA, 1-MG, and 8-OHdG were 2.19, 2.1, and 7.3 µmol/mmol creatinine, respectively. The concentrations of 1-MA, 1-MG, and 8-OHdG were significantly higher in breast cancer patients, especially in the early-stage. The combination of three urinary metabolomes with CA15-3 improves the diagnostic sensitivity of breast cancer. For the combined score, the area under the curve (AUC) value of combined score ranged from 0.820 to 0.950, with high accuracy, ranged from 77.0 to 95.5%. The most significant AUC (0.973), sensitivity (90.1%), selectivity (94.0%) was recorded at comparing the healthy control with the early-stage of malignant breast cancer. In conclusion, the combination of three urinary metabolomes with serum CA15-3 improves the diagnostic sensitivity of breast cancer.  相似文献   

14.
Acid challenge test was carried out on 87 subjects (37 normal and 50 radiologically proven stone formers) to assess their renal acidification capacity. NS were given three doses viz. 75, 100 and 150 mg NH4Cl/Kg body weight while the SF were tested with only 150 mg dose which was found to be an adequate dose. Ammonium chloride was given in gelatin capsules with breakfast and hourly urine samples were collected for next 7 hours. pH, creatinine, calcium, inorganic phosphorus, citrate, titrable acid and ammonium were analysed in all the samples. The incidence of renal tubular acidosis (RTA) in NS, tested with 75 mg and 100 mg/kg doses of ammonium chloride, was 50% and 10% respectively while it was nil and 24% respectively in NS and SF tested with 150mg/kg dose. Complete RTA was detected in one SF. No significant difference was observed in urinary profile of NS and SF except that the hourly titrable acid excretion was lower in later. A comparison between with and without RTA SF revealed that titrable acid and phosphate excretion decreased in RTA defect. Overall data indicate that (a) RTA was an etiologic factor in one fourth of the SF; (b) an oral acid challenge test is a good adjunct to detect this condition and (c) acid challenge increases calcium, phosphate and titrable acid excretion and decreases citrate.  相似文献   

15.
Effect of irbesartan, an angiotensin II receptor antagonist, was studied in streptozotocin (STZ) induced diabetic nephropathy. Polyuria, proteinuria, blood urea, creatinine clearance, and urinary electrolytes were determined to assess kidney damage. There was a significant increase in urine volume, urinary protein and blood urea in STZ induced diabetic rats. On the other hand, irbesartan treatment resulted in a significant reduction in urinary protein and blood urea in these rats. Irbesartan treatment also improved creatinine clearance and exhibited a natriuretic effect in these animals. Results suggest that irbesartan treatment ameliorate STZ induced diabetic nephropathic changes, in rats.  相似文献   

16.
Daily urinary follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) levels were estimated in a group of 10 normal one month old male infants. Four-hourly urine samples were collected from each infant over a three months period i.e., from one month to four months of infants age. The hormonal levels were expressed as mIU of FSH, LH and ng of T per mg creatinine. The normal hormonal pattern thus obtained could be used to compare patterns obtained from pathological cases or when monitoring the effects of drugs on infants.  相似文献   

17.

Introduction

Urinary tract infection (UTI) is one of the most common types of infection. Currently, diagnosis is primarily based on microbiologic culture, which is time- and labor-consuming. The aim of this study was to assess the diagnostic accuracy of urinalysis results from UriSed (77 Electronica, Budapest, Hungary), an automated microscopic image-based sediment analyzer, in predicting positive urine cultures.

Materials and methods:

We examined a total of 384 urine specimens from hospitalized patients and outpatients attending our hospital on the same day for urinalysis, dipstick tests and semi-quantitative urine culture. The urinalysis results were compared with those of conventional semi-quantitative urine culture.

Results:

Of 384 urinary specimens, 68 were positive for bacteriuria by culture, and were thus considered true positives. Comparison of these results with those obtained from the UriSed analyzer indicated that the analyzer had a specificity of 91.1%, a sensitivity of 47.0%, a positive predictive value (PPV) of 53.3% (95% confidence interval (CI) = 40.8–65.3), and a negative predictive value (NPV) of 88.8% (95% Cl = 85.0–91.8%). The accuracy was 83.3% when the urine leukocyte parameter was used, 76.8% when bacteriuria analysis of urinary sediment was used, and 85.1% when the bacteriuria and leukocyturia parameters were combined. The presence of nitrite was the best indicator of culture positivity (99.3% specificity) but had a negative likelihood ratio of 0.7, indicating that it was not a reliable clinical test.

Conclusions:

Although the specificity of the UriSed analyzer was within acceptable limits, the sensitivity value was low. Thus, UriSed urinalysis results do not accurately predict the outcome of culture.  相似文献   

18.
Uric acid in urine was analyzed using porcine liver uricase and horseradish peroxidase immobilized on alkylamine and arylamine glass beads (pore diameter 55nm) respectively. The minimum detection limit was 5.0mg/0.1 ml urine. The recovery of added uric acid was 92%. Within and between assay CVS were <1.3% and <5.3% respectively. A good correlation (r=0.93) was found between urinary urate values obtained by a commercial kit method and the present method. The uric acid in 24hr urine of apparently healthy adults and person sufering from various diseases was found to be 450 to 900mg/24hr, 659mg/24hr (range, mean) and 910–1400mg/24hr, 1145 mg/24hr (range, mean) respectively with the present method.  相似文献   

19.
Fluoride content was measured in 100 urinary stones retrieved by open surgery of stone formers admitted at PGIMS Rohtak and their respective urine and serum and compared with those of healthy individuals. The concentration of fluoride was also measured in the sources of drinking water of these stone formers. The concentration of fluoride was definitely significantly higher in serum (p>0.01) and highly significantly higher in urine (p>−0.001) of stone formers compared to those of healthy individuals. The content of oxalate in serum and 24 h urine of the stone formers was also measured, which was increased significantly (p<0.005 and p<0.001) compared to healthy individuals. The concentration of fluoride was probably significantly higher in drinking water of these stone formers than the normal ones. There was a positive correlation between the content of fluoride of urinary stones and urine of stone patients (r=.88); stone and serum (r=.62); drinking water and stone (r=.85) and their urine and serum (r=.54); urine and drinking water (r=.83) and serum and water (r=.51). These results indicate a definite role of fluoride in urinary stone formation.  相似文献   

20.
The extract of Jatropha Gossypifolia stem was obtained by cutting the stem with a sharp knife and the fluid expressed out. The suitability of the stem latex extract as a precipitant for biochemical analysis was determined. The precipitating efficacy of the extract for creatinine and protein estimation was found to be optimum at 1/4 and 1/5 dilutions respectively aqueous solution. Plasma protein was precipitated with stem extract of J. Gossypifolia at the stated dilution. The mean plasma creatinine values obtained from 0.5 % sodium tungstate as a protein precipitant were compared with the values of plasma creatinine obtained when ¼ dilution of stem extract of J. Gossypifolia was used as protein precipitant. Similarly mean cerebrospinal fluid (CSF) and urinary protein values obtained from 3 % Tricholoro-acetic acid as protein precipitant were compared with values obtained from 1/5 dilution of stem extract of J. Gossypifolia as protein precipitant. The values obtained from the stem latex extract at the stated dilutions were comparable with values obtained from the conventional protein precipitants (p < 0.05). The stem latex extract of J. Gossypifolia is suitable as a protein precipitant for creatinine, CSF and urinary protein estimations. However further work need to be done to purify the extract and determine the exact concentration at the stated dilutions as well as the active ingredient in stem latex.  相似文献   

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