Urine fetuin-A values in relation to the presence of urolithiasis.

OBJECTIVE: To investigate the relationship of urine fetuin-A and other promotors and inhibitors of urine crystalization with urolithiasis, as fetuin-A inhibits the precipitation of hydroxyapatite from supersaturated solutions of calcium and phosphate in vitro but no information on urine fetuin-A in patients with urolithiasis is available. PATIENTS AND METHODS: In all, 39 patients with urolithiasis and 22 individuals with no urolithiasis or probands with undetected stones were involved. All patients underwent kidney ultrasonography and X-ray examination, and body mass index (BMI) was calculated. Serum creatinine, parathyroid hormone, calcium, magnesium, anorganic phosphate, uric acid and urine creatinine, albumin, alpha(1)-microglobulin, sulphate, oxalate, citrate and fetuin-A (ELISA) were determined. RESULTS: The patients with urolithiasis had lower urine fetuin-A levels (median 4.9 vs 0.77 mg/day; P < 0.01) and citraturia levels (1.7 vs 5.1 mmol/day; P = 0.02); and higher calciuria (6.5 vs 5.2 mmol/day) and oxaluria (0.47 vs 0.25; P = 0.04). Patients with fetuin-A levels in the lowest quartile had an odds ratio of 36 compared with individuals in the highest quartile. The sensitivity of the urine fetuin-A level for urolithiasis was 97.4% and specificity was 100% (area under the curve 0.99; 95% confidence interval 0.94-1.0) using a urine fetuin-A threshold of

Urinary clusterin concentrations--a possible marker of nephropathy? Pilot study.

BACKGROUND: Clusterin is a glycoprotein which participates in a number of pathophysiological processes in the organism. Information about clusterin use in the diagnosis of nephropathy and the differential diagnosis of proteinuria has been published recently. AIM: Search for correlations between urinary clusterin concentration and other renal function markers. Evaluation of urinary clusterin measurement use in the differential diagnosis of nephropathy. METHODS: Urea, creatinine, IgG, transferin, Na, K in serum and 24-hour collected urine were measured in a sample of 82 individuals. Cystatin C in sera was also measured as were GMT, alpha-1 microglobulin, albumin, total protein in urine. In all probands urinary clusterin was assayed (ELISA). RESULTS: Urinary clusterin values correlated with urinary total protein concentrations (r = 0.28; p = 0.018), total protein/creatinine index (r = 0.26; p = 0.02). No correlation was found between urine clusterin concentration and glomerular filtration rate, age, urine GMT/creatinine, alpha-1-microglobulin, urine albumin and albumin/creatinine ratio or Na, K fractional excretions. We found no urinary clusterin differences by sex of probands. No evidence of any relationship between urine clusterin and presence of defect of renal function, number of risk factors (chi(2) = 16.0; DF = 15; p = 0.38), albumin/creatinine index (chi(2) = 0.76; DF = 3; p = 0,86), total protein/creatinine (chi(2) = 6.5; DF = 3; p = 0.09), GMT/creatinine (chi(2) = 2.3; DF = 3; p = 0.51), high urinary alpha-1-microglobulin (chi(2) = 4.1; DF = 3; p = 0.25) or decreased of GFR (chi(2) = 1.3; DF = 3; p = 0.74). CONCLUSIONS: A positive correlation exists between urinary clusterin and urinary total protein and total protein/ creatinine index. Urinary clusterin measurement with ELISA test does not offer any advantage over routinely used parameters for nephropathy diagnosis and the differential diagnosis of proteinuria type.

Use of glycogen phosphorylase BB measurement with POCT in the diagnosis of acute coronary syndromes. A comparison with the ELISA method.

BACKGROUND: Glycogen Phosphorylase BB (GPBB) is considered an early and specific marker of myocardial necrosis and ischemia. A POCT kit GPBB for diagnostic use has recently been approved. AIM: an evaluation of the correspondence of qualitative POCT GBPP measurements with ELISA test results. MATERIAL AND METHODOLOGY: 20 individuals with non-ST elevation myocardial infarction (non-STEMI) and 20 probands without acute coronary syndrome (ACS) were tested. GPBB (POCT, ELISA) in venous plasma (lithium-heparin) was assayed in all probands. RESULTS: individuals with non-STEMI had significantly higher GPBB ELISA values (32.3 vs. 6.1 microg/l; p < 0.01). GPBB sensitivity and specificity for non-STEMI presence 6 hours after chest pain generation were 100 %. No proband was classified in a different subgroup with POCT of GPBB (positive/negative). GPBB POCT correlate with a non- STEMI diagnosis (chi(2) 36.1; p <0.01). CONCLUSION: GPBB POCT measurement is comparable with ELISA test results. GPBB analysis could expand the diagnostic palette in the first hours after the onset of acute coronary syndrome.

Assessment of serum beta-trace protein (BTP) measurement in the prediction of glomerular filtration rate. Comparison with serum cystatin C.

Serum BTP measurement is sometimes believed to be an alternative marker of glomerular filtration rate (GFR) assessment. The aim of the present work was to investigate the correlation between creatinine, cystatin C, and BTP values in sera and to compare the diagnostic efficacy for serum BTP and cystatin C with the glomerular filtration rate estimate. 25 individuals were tested. GFR was estimated from creatinine clearance, serum cystatin C and BTP and urine alpha-1 microglobulin, albumin, GMT and creatinine were measured. BTP values correlated with cystatin C (r = 0.75; p < 0.01), creatinine (r = 0.73, p < 0.01), GFR (r = -0.46; p = 0.02), urine alpha-1-microglobulin (r = 0.66; p < 0.01). The diagnostic efficacy of BTP for reduced GFR was insufficient and the calculation of GFR with BTP was not included in the regression model.

Guanylins--agents with natriuretic effect.

Guanylins and uroguanylins are natriuretic peptides with different effects in many of tissues. In context with guanylins, the intestine-renal axis is presented. The overproduction of guanylin or uroguanylin leads to secondary diarrhea with stimulation of Cl(-) secretion. A diet high in salt lead especially to increased guanylin and uroguanylin secretion. Interesting applications with guanylins measurement could to be in hypertension diagnosis, monitoring of heart dysfunction treatment, intensive care etc.

Adiponectin added into the plasma of healthy probands does not affect platelet aggregability.

Six healthy non-obese probands without medical therapy and history of disease were tested. In all of them platelet aggregability with addition of human recombinant adiponectin in different concentrations (100; 75; 50 and 25 ng/l) were measured. It is concluded that increased level of adiponectin has no significant antiaggregation effect on platelets from individuals without hypoadiponectinemia.

Evaluation of urine N1,N12-Diacetylspermine as potential tumor marker for urinary bladder cancer.

BACKGROUND: N1,N12-diacetylspermine, a diacetylpolyamine which was recently identified in urine, appeared to be a useful tumor marker for a number of cancers. No valid data on urine diacetylspermine concentration in patients with urinary bladder cancer exist. AIM: Evaluation of urine N1,N12-diacetylspermine concentrations in individuals with urinary bladder cancer. METHODS: Urine samples were used from 36 patients with urothelial tumors of the urinary bladder and from 30 patients with benign urological diseases. Urine was collected before cystoscopy. Enzyme-linked immunoabsorbent assays (ELISA) were performed for diacetylspermine from urine. RESULTS: Urine diacetylspermine did not differentiate in individuals with urinary bladder cancer from controls (medians 171.5 vs 143.8, p = 0.64). Its efficacy for urinary bladder cancer detection was not shown. CONCLUSIONS: Urine N1,N12-diacetylspermine is probably not a useful marker for urinary bladder cancer.