PubMed · 5503564
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E Horáková, Z Kulenda, A Libický. 1970. [A simple method for creatinine determination].. https://pubmed.ncbi.nlm.nih.gov/5503564/
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The value of urine flow cytometry (UFC) in diagnosing acute renal allograft rejection (AR) was recently established in a prospective double-blind study. In this study, we report the 1-year follow-up of three groups of patients identified during the previous study: group 1--stable patients (no ARs) with persistently negative UFCs (n=7); group II--patients who had early ARs (<3 months after transplantation), with positive UFCs that completely normalized with antirejection therapy (n=8); group III--stable patients (no ARs) with positive UFCs (n=7). By definition, group III consists of patients previously considered to have "false positive" UFCs. All patients received standard immunosuppressive therapy, with regimens that included cyclosporine at doses adjusted to maintain target levels. Serum creatinine (SCr) levels (mg/dl) were similar in all three groups at 1 month after transplantation. However, at 1 year after transplantation, SCr was 1.4 +/- 0.2 in group I, 2.0 +/- 0.9 in group II, and 1.9 +/- 0.3 in group III (P=0.004 group I vs. group III). There were no ARs clinically diagnosed during this follow-up period in any of the three groups of patients, but there were significantly higher SCr increments among group III patients after the 1 year of follow-up. The detection of an active urine sediment by flow cytometry in "clinically stable" allograft recipients may indicate ongoing, subclinical acute rejection activity, which in this study was found to be associated with worse renal function at the end of the first posttransplant year as compared with patients with persistently negative UFCs. Increased immunosuppression may be indicated for these patients with persistently positive UFCs.
We have been interested in the clinical use of capillary electrophoresis (CE) to monitor low-molecular-mass uremic toxins in body fluids. Creatinine, an important clinical marker for renal failure, is zwitterionic over a fairly wide pH range (pH 5-9) and can not be resolved from neutral components using free solution CE under these conditions. We report here a micellar electrokinetic capillary chromatography method using an sodium dodecyl sulfate-borate buffer system at pH 9.0 to determine creatinine levels in human serum. This method, performed on deproteinized sera, is also suitable for determining multiple ionic components. Moreover, this method compares favorably with an enzymatic method for creatinine performed in a clinical laboratory and thus appears to be a promising method in terms of potential clinical use.