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PubMed1986

[Comparative quantitative clinico-chemical analysis of the characteristics of 24-hour urine and morning urine].

Ten clinical chemical parameters were used to investigate the relationship between morning urine and 24-hour urine in 80 healthy probands. During the period of the investigation there were no dietary restrictions. A period of at least 4 hours was required between the previous micturation and the collection of morning urine. The following parameters were determined: sodium, potassium, chloride, creatinine, urea, uric acid, glucose, calcium, inorganic phosphorus and total protein. Every parameter, with the exception of total protein, was determined without prior manual dilution, by a fully mechanized procedure, using a multichannel analyser SMA 12/60 (Technicon) adapted for routine purposes. The data showed: The scatter of the excretory values is generally lower in 24-hour urine than in morning urine, but collectively the reference intervals are relatively wide. Almost without exception, there is a significant correlation between excretion in the 24-hour and morning urines, but the average correlation coefficient is only 0.5. The determined reference intervals (10/90 percentile) for the concentrations of the parameters in 24-hour and morning urines are largely in agreement. It is concluded from the data that the composition of morning urine of apparently healthy probands adequately reflects excretion of 24 hours. It remains to be seen whether this is also true for pathological states.

Adult↗
PubMed1993

Effectiveness of buspirone on urine spraying and inappropriate urination in cats.

The most frequent type of behavior problem in cats for which veterinary consultation is sought is problem urination. Urine spraying and urine marking have been treated by use of long-acting progestins and diazepam, a benzodiazepine antianxiety drug. Effectiveness of the nonbenzodiazepine antianxiety drug, buspirone, in suppressing urine spraying and marking in 47 male and 15 female cats was evaluated. The effect of the drug in correcting inappropriate urination in 9 cats also was evaluated. Buspirone resulted in a favorable response (> 75% reduction) in 55% of cats treated for urine spraying or marking. There was no sex difference in effectiveness of the treatment, but cats from single-cat households responded favorably significantly (P < 0.001) less frequently than those from multiple-cat households. The 55% response rate was within the range of treatment effectiveness that has been reported for diazepam, and was greater than that reported for progestin. In contrast to diazepam, with which over 90% of treated cats resumed spraying or marking when the drug was gradually discontinued, only half of the cats treated with buspirone resumed spraying when the drug was discontinued after 2 months of treatment (P < 0.001). This difference between diazepam and buspirone in resumption of urine spraying was attributed to diazepam's induction of physiologic and behavioral dependency, not found with buspirone. Cats that resumed spraying were placed on long-term treatment ranging from 6 to 18 months. Buspirone also did not cause the adverse effects of sedation and ataxia, which commonly are seen with diazepam treatment. In cats treated for inappropriate urination, 56% returned to normal litter box usage.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1998

Urine activity of cathepsin B, collagenase and urine excretion of TGF-beta 1 and fibronectin in membranous glomerulonephritis.

In 30% of cases nephrotic syndrome is caused by membranous glomerulonephritis (MG). Protein accumulation in glomeruli leads to progressive loss of kidney function and damage of structure in MG. The role of tissue proteolytic systems and growth factors in this process is not known. The purpose of the study was to estimate urine cathepsin B, collagenase activity and urine excretion of TGF-beta 1 and fibronectin in MG. Cathepsin B activity was greater in the urine of MG patients than in the control group (10.58 +/- 8.73 pmol AMC/mg creatinine per min-1 vs control 7.11 +/- 2.05 pmol AMC/mg creatinine per min-1; P < 0.05). Urine collagenase activity was higher in the group of patients than in the control group (8.59 +/- 4.26 pmol AMC/mg creatinine per min-1 vs control 3.84 +/- 2.09 pmol AMC/mg creatinine per min-1 P < 0.02). Urine excretion of fibronectin (45.60 ng/mg creatinine vs control 10.30 ng/mg creatinine; P < 0.04) and TGF-beta 1 levels in the urine were higher than in controls (283.55 +/- 248.13 pg/ml vs 36.11 +/- 48.01 pg/ml; P < 0.01). Results suggest glomerular overproduction of TGF-beta 1 and urinary leak of proteolytic enzymes (PE). This may result in decreased glomerular PE activity in MG and, with time, may lead to protein accumulation in renal glomeruli and to progressive loss of kidney function and damage of structures as the course of MG progresses. PE urine composition as well as ECM protein and cytokine urine excretion may allow noninvasive glomerulopathy course monitoring in humans in the future.

Adult↗
PubMed1995

The urine protein to creatinine ratio as a predictor of 24-hour urine protein excretion in type 1 diabetic patients with nephropathy. The Collaborative Study Group.

The purpose of this study was to determine the usefulness of a random urine specimen protein to creatinine (P/C) ratio in predicting 24-hour urine protein excretion (24 UP) in type 1 diabetic patients with overt nephropathy. Two hundred twenty-nine outpatient diabetic subjects enrolled in the Collaborative Study Group's multicenter clinical trial of "Angiotensin-Converting Enzyme Inhibition in Type 1 Diabetic Nephropathy" provided specimens for study, which encompassed a wide range of proteinuria (0.05 to 13.3 g/d). Twenty-four hour urine collections for total protein and creatinine (g/d) were obtained in the outpatient setting. This was followed shortly thereafter by an untimed single urine specimen for protein and creatinine (mg/dL). For longitudinal analysis, 33 patients provided two 24-hour urine collections with concomitant random urine specimens, separated by at least a 3-month period. Across the range of proteinuria that we studied, the log random urine P/C ratio correlated to log 24 UP (r = 0.90). The regression line was almost identical to the line of unity, which indicates that a patient's 24 U/P (in g/d) can be predicted directly from the random urine specimen P/C ratio (P/C = 24 UP in g/d). However, the standard deviations associated with these predictions were large, especially at the higher 24 UP values. Of the 33 patients who provided two time-separated specimens, the direction of change in P/C ratio was discordant with the direction of change in 24 UP in 14 of the 33 repeat specimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Blood urea concentration, a parameter for the assessment of protein metabolism in pregnant sows. 2. Relations between blood urea concentration and urine nitrogen excretion as well as estimation of urine nitrogen excretion from the blood urea concentration].

The influence of supplementing the ration with the limiting amino acid lysine on N-excretion in urine and the urea concentration in the blood (UCB) is investigated in an experiment with pregnant young sows. In contrast or the basic ration the most satisfactory N-utilisation reflects itself after a lysine intake of 8.2 g/animal and day during the early phase of gestation and 8.6 g during the last phase of gestation both in a diminished N-excretion in urine and a lower UCB. The following correlation coefficients were calculated for the relation between UCB an N-excretion in urine: early phase of gestation: 0.177 (n = 37); last phase of gestation. 0.431 (n = 30); gestation as a whole: 0.416 (n = 67). In a second experiment methionine supplementation in the feeding of a ration with a deficit of sulphur-containing amino acids led to a significant decrease of N-excretion in urine (alpha = 5%). While UCB also significantly decreased 5 hours after feeding, UCB virtually did not react to a changed level of amino acid intake when the blood sample was taken before feeding. In a third experiment, in which 49 g N/animal and day were taken in, differences regarding N-excretion in urine and UCB between pregnant and non-pregnant animals could not be established. When the results published in the first communication (Herrmann and Schneider, 1981) are included, the following correlation coefficients for the relation between N-excretion in urine and UCB are the result: 0.716 (n = 182) for sampling before feeding and 0.808 (n = 133) for sampling 5 hours after feeding. The confidence range of the estimated function y = -2.97 + 1.233 chi for the relation between N-excretion in urine (y; g/animal and day) and UCB 5 hours after feeding (chi; mg/100 ml serum) as well as the variability values do not make it possible to estimate N-excretion in urine from UCB with satisfactory accuracy.

Animals↗
PubMed2001

The urine protein to creatinine ratio (P/C) as a predictor of 24-hour urine protein excretion in renal transplant patients.

BACKGROUND: The purpose of this study was to examine the utility of the random urine protein to creatinine ratio (P/C) in evaluation and longitudinal management of proteinuria in adult renal transplant recipients with or without overt nephropathy in an outpatient clinic. METHODS: A total of 289 adult renal transplant recipients provided 24-hr urine collections for total protein and creatinine, followed by a random urine for protein and creatinine. For longitudinal analysis, 192 of these patients provided two 24-hr urine collections with concomitant random urine specimens separated on average by 6.8 months. As well, 134 patients provided a total of 851 multiple-paired spot and 24-hr urine samples (range 2 to 12) over a 2-year period. RESULTS: The log random urine P/C ratio correlated significantly to the log 24 UP (r=0.749, P<0.0001) with or without nephrotic range proteinuria. High sensitivity (74.4-90%) and specificity values (93-98%) were found for estimating proteinuria from 0.5 to 2 g/day. However, the precision of estimation decreased as the level of urinary protein excretion increased to >3 g/day. The positive predictive value decreased as proteinuria became >3 g/day, perhaps because of the low prevalence of patients with high level proteinuria in our sample. The direction of change in P/C ratio longitudinally was accompanied by a similar direction of change in 24 UP, which was highly significant (r=0.7555, P<0.0001). CONCLUSION: We conclude that the urine P/C ratio is a useful and convenient screening and longitudinal test for proteinuria.

Adolescent↗
PubMed2006

Can spot urine protein/creatinine ratio replace 24 h urine protein in usual clinical nephrology?

BACKGROUND: This prospective study was designed to assess whether a single urine specimen, collected at the time of clinical assessment, could be used to estimate 24 h urinary protein excretion. METHODS: The spot urinary protein/creatinine ratio (P/Cr) and 24 h urine protein and creatinine excretion were determined from 103 patients attending a nephrology clinic. Using the spot urine P/Cr, a regression equation was derived, predicting 24 h protein excretion. The performance of the regression equation was tested on a new cohort of 85 patients. Within this new cohort, agreement between the predicted and the actual 24 h urinary protein excretion was assessed using the Bland-Altman technique. The ability of spot urine P/Cr and dipstick urinalysis to predict different threshold levels of protein excretion was assessed using a series of receiver operator curves. RESULTS: A logarithmic relationship exists between the spot P/Cr and 24 h protein excretion, with a correlation of 0.92, P < 0.0001. Agreement between the actual and predicted 24 h urine protein and between spot and 24 h urine P/Cr ratios was suboptimal at higher levels of protein excretion. Discriminant spot urine P/Cr values reliably predicted protein excretion thresholds of 0.3, 0.5, 1.0 and 3.0 g/day. Urinalysis was a poor test for quantitating protein excretion. CONCLUSION: Random spot urinary P/Cr predicts actual 24 h protein excretion with reasonable accuracy in patients with lower levels of protein excretion but is unreliable in patients with high protein excretion and should not be used in the clinical setting unless 24 h urine collection is unavailable.

Cohort Studies↗
PubMed1976

[Comparative experiments on erythropoietin concentrations in ultrafiltered urine (Diaflo-process) and urine dialysis with higher osmolar substances (Carbowax( (author's transl)].

The Diaflo-ultrafiltration process with polyion membranes, UM 10, PM 10, and PM 30 for the determination of erythropoietin concentration in urine is compared with the method of urine dialysis in Visking tubes against Carbowax. The aberage regain of animal erythropoietin in human urine by ultrafiltration with the UM 10-membrane is 84%, with the PM 10-membrane 62%,with the PM 30-membrane 17% and with urine dialysis 71%. Mice show a lower toleration for the UM 10 concentrates than for the concentrates prepared by urine dialysis. The concentrates of kidney patients also cause a higher mortality in the animals. The concentrates are tolerated when equal amounts of urine components are incorporated in a three times larger volume and this is divided into three separate injections. Mice with polyglobulia tolerate urine concentrates when not more than 6% of a whole contrate of a 24-hours-urine per mouse is injected in the peritoneum. There is a low iron incorporation rate in the mice that show a strongly toxic reaction.

Animals↗
PubMed2000

Defects in pyrimidine degradation identified by HPLC-electrospray tandem mass spectrometry of urine specimens or urine-soaked filter paper strips.

BACKGROUND: Urinary concentrations of thymine, uracil, and their degradation products are useful indicators of deficiencies of enzymes of the pyrimidine degradation pathway. We describe a rapid, specific method to measure these concentrations to detect inborn errors of pyrimidine metabolism. METHODS: We used urine or urine-soaked filter-paper strips as samples and measured thymine, uracil, and their degradation products dihydrothymine, dihydrouracil, N:-carbamyl-ss-aminoisobutyric acid, and N:-carbamyl-ss-alanine. Reversed-phase HPLC was combined with electrospray ionization tandem mass spectrometry, and detection was performed by multiple-reaction monitoring. Stable-isotope-labeled reference compounds were used as internal standards. RESULTS: All pyrimidine degradation products could be measured in one analytical run of 15 min. Detection limits were 0.4-4 micromol/L. The intraassay imprecision (CV) of urine samples with added compounds was 1.3-12% for liquid urines and 1. 0-10% for filter-paper extracts of the urines. The interassay imprecision (CV) was 3-11% (100-200 micromol/L). Recoveries were 89-99% at 100-200 micromol/L and 95-106% at 1 mmol/L in liquid urines, and 93-103% at 100-200 micromol/L and 100-106% at 1 mmol/L in filter-paper samples. Correct identifications of deficiencies of the pyrimidine-degrading enzymes were readily made with urine samples from patients with known defects. CONCLUSIONS: HPLC with electrospray ionization tandem mass spectrometry allows rapid testing for disorders of the pyrimidine degradation pathway, and filter-paper samples allow easy collection, transport, and storage of urine samples.

Chromatography, High Pressure Liquid↗
PubMed2002

Using the urine dipstick to screen out unnecessary urine cultures: implementation at one facility.

This study examined the utility of performing urine cultures on biochemically negative urine specimens and details the implementation of a policy to cancel these cultures. Four reactions of the Multistix SG (Bayer, Elkhart IN) urine dipstick (protein, occult blood, leukocyte esterase, and nitrite) were used as biochemical indicators. A three-month retrospective study examining the results of 843 urinalysis/ urine culture pairs indicated that one-third of these cultures were probably unnecessary (negative dipstick/negative culture). Based on these results, a policy was implemented to screen those urine samples having both a urinalysis and urine culture ordered. Over a six-month period, 6,192 urine specimens were evaluated. Of these, 36% (2,260 cultures) were cancelled. Of the 3,932 samples cultured 22.4% (883) were true positives (positive dipstick/positive culture) while 31.6% (1245) had a positive dipstick but grew organisms considered contaminants. The false positive rate was 40% (positive dipstick/negative culture), and the false negative rate was 6%. Implementation of this policy reduced the number of urines cultured by 36%.

Algorithms↗
PubMed1991

Effect of urine and urine components on the chemiluminescent response of bacteria-stimulated polymorphonuclear leukocytes.

The role of polymorphonuclear leukocytes (PMN) found in urine during infectious episodes is still unknown. Opsonophagocytosis of Escherichia coli by normal blood PMN in the presence of urine was measured using a chemiluminescence (CL) assay. PMN were challenged by a type I fimbriated E. coli strain shown to elicit a CL response through attachment to the mannose-containing receptors on the leukocytes. In the presence of urine the CL response decreased significantly. Urine osmolality due to inorganic salts partially caused this decrease. A higher inhibitory effect was elicited by urea. Under otherwise similar conditions, the presence of an additional CL-inhibiting factor, most probably a protein, was detected in urine; however, its identity has not yet been defined. In vitro and in vivo urine dilution improved PMN function. No difference in effect on CL response was found between urine obtained from 25 children with recurrent urinary tract infections and urine from 15 age-matched controls.

Adolescent↗
PubMed2003

Combining urine separation with waste design: an analysis using a stochastic model for urine production.

This paper explores the stochastic properties of human urine production in order to assess the potential of combining urine separation with waste design. The aim is to provide specific information about the dynamics of urine production at a microscopic level for the design and the control of the urine waste stream. Based on measured data a stochastic model is developed that is capable of providing stochastic information on the frequency, timing, and volume of urine releases into each single toilet in a catchment. It is then demonstrated in a virtual case study that the design of the human wastewater stream in terms of urine content can (1) reduce the ammonia peak loads at dry weather flow conditions by approx. 30% (which could effectively substitute the expansion of wastewater treatment plants) and (2) reduce the impact of combined sewer overflows on the aquatic environment. With respect to the latter a reduction of more than 50% is demonstrated in terms of annual urine volume released via the overflow.

Ammonia↗
PubMed2003

High urine volume and low urine osmolality are risk factors for faster progression of renal disease.

BACKGROUND: Increased fluid intake slows renal disease progression in animal models. The relevance of these findings to human renal disease is not clear, although increased fluid intake often is recommended to patients with chronic renal insufficiency. This study tested the hypothesis that urine volume, urine osmolality (Uosm), or both are significantly associated with glomerular filtration rate (GFR) decline in patients with chronic renal insufficiency. METHODS: This is a retrospective analysis of Modification of Diet in Renal Disease (MDRD) study A patients with (N = 139) and without polycystic kidney disease (PKD; N = 442). The key outcome measure was GFR slope in relation to mean 24-hour urine volume and Uosm during follow-up in study A (mean, 2.3 years). RESULTS: The regression of GFR slope on mean follow-up 24-hour urine volume (adjusted for body surface area and MDRD diet and blood pressure group) showed that the greater the urine volume, the faster the GFR decline in patients both with and without PKD. For example, the difference in GFR slope for those with a mean follow-up 24-hour urine volume of 2.4 versus 1.4 L was -1.01 mL/min/y (confidence interval, -0.27 to -1.75) for patients without PKD and -1.20 mL/min/y (confidence interval, -0.06 to -2.34) for those with PKD. A similar but inverse relationship was shown between GFR decline and mean 24-hour Uosm in patients with (P = 0.01) and without PKD (P = 0.001). These associations remained significant after adjustment for 13 relevant baseline and follow-up covariates. CONCLUSION: Sustained high urine volume and low Uosm are independent risk factors for faster GFR decline in patients with chronic renal insufficiency. Thus, high fluid intake does not appear to slow renal disease progression in humans. We suggest that until better evidence becomes available, patients with chronic renal insufficiency should generally let their thirst guide fluid intake. The advice to avoid "pushing fluids" might be particularly important for patients with PKD.

Disease Progression↗
PubMed1997

750 MHz 1H NMR spectroscopy characterisation of the complex metabolic pattern of urine from patients with inborn errors of metabolism: 2-hydroxyglutaric aciduria and maple syrup urine disease.

750 MHz 1H NMR spectroscopy has been used to characterise in detail the abnormal low molecular weight metabolites of urine from two patients with inborn errors of metabolism. One case of the rare condition 2-hydroxyglutaric aciduria has been examined. There is at present no rapid routine method to detect this genetic defect, although NMR spectroscopy of urine is shown to provide a distinctive pattern of resonances. Assignment of a number of prominent urinary metabolites not normally seen in control urine could be made on the basis of their known NMR spectral parameters including the diagnostic marker 2-hydroxyglutaric acid, which served to confirm the condition. In addition, 750 MHz 1H NMR spectroscopy has been used to characterise further the abnormal metabolic profile of urine from a patient with maple syrup urine disease. This abnormality arises from a defect in branched chain keto-acid decarboxylase activity and results in a build up in the urine of high levels of branched chain oxo- and hydroxy-acids resulting from altered metabolism of the branched chain amino acids, valine, leucine and isoleucine. A number of previously undetected abnormal metabolites have been identified through the use of one-dimensional and two-dimensional J-resolved and COSY 750 MHz 1H NMR spectroscopy, including ethanol, 2-hydroxy-isovalerate, 2,3-dihydroxy-valerate, 2-oxo-3-methyl-n-valerate and 2-oxo-isocaproate. NMR spectroscopy of urine, particularly when combined with automatic data reduction and computer pattern recognition using a combination of biochemical markers, promises to provide an efficient alternative to other techniques for the diagnosis of inborn errors of metabolism.

Amino Acid Metabolism, Inborn Errors↗
PubMed1985

Evaluation of the pelvioureteral function through a new urine bolusmetry: simultaneous measurement of urine bolus volume and electroureterogram.

New equipment to evaluate the urine transport function of the ureteropelvic system has been developed. Simultaneous measurement of urine bolus volume and electrical activity in the ureter is possible by means of this equipment. A urine bolus volume measuring system, which is based on the heat electrical method, is located in the probe tip, and bipolar electrodes for EMG are located in the stem of the Fr. 4 ureteral catheter. Two kinds of experiments were performed. One was an examination of the new probe through a pervioureteric model using an infusion pump and Nelatons' catheters of various diameters. The other was an animal experiment. The changes in ureteral peristalsis and urine bolus volume in response to diuretics were examined in mongrel dogs through application of this equipment. The following results were obtained: There was a logarithmic relation between perfusion flow rate in catheters used as ureteral models and the values of voltage depression measured by the heat electrical method. The urine bolus volume was calculated closely through a formula which had been developed from the model experiments. In animal experiments, the bolus volume increased significantly and a transient increase in peristalsis was noted after the administration of diuretics although there was no significant change in peristaltic velocity. Some pelvioureteric function parameters, i.e. peristaltic frequency, peristaltic velocity, urine bolus volume, volume, bolus length and ureteral width, are feasible calculations. These results indicate that bolusmetry by using this new probe is a valuable method for evaluation of urine transport function in the pelvioureteric system, and suitable for clinical use as well as animal experiments.

Animals↗
PubMed1977

Contamination of rat urine with gut flora using all-glass metabolism cages for collection of urine and faeces.

In rat urine collected in all-glass metabolism cages, at least four strains of intestinal microflora were found: two types of E. coli, Enterobacter cloaceae and Proteus vulgaris. The number of bacteria of each strain increased with time. 2. The pH of the urine increased from 6-9 after 24 h to 8-95 after 120 h. The pH of the urine of neomycin-treated rats remained nearly constant over a period of two days. 3. Nitroreductase activity was present in the rat urine. Added p-nitrobenzoic acid was reduced within the first 24 h. Nitroreductase activity in the urine of neomycin-treated rats was significantly lower than in the urine of normal rats, during the second 24-h period only. 4. Collection of urine at -10 degrees prevented the consequences of contamination.

Animals↗
PubMed1995

Diagnostic value of urine cytology and urine carcinoembryonic antigen (CEA) level in the distinction between bladder cancer and urinary tract infection.

In the retrospective investigation we estimated the CEA levels in urine and urine cytology in 293 patients with urinary bladder cancer (group I) and in 129 patients with urinary tract infection (group II). An increased CEA level was found in 212 cases of bladder cancer and in 109 cases of urinary infection. Neoplastic cells in urine sediment were identified in 254 cases in the first group, while in the second, multiple inflammatory cells and pyuria were diagnosed in 55 and 56 cases, respectively. The combined examination (increased CEA level and/or positive cytology of the urine sediment) allowed for the diagnosis of neoplastic disease in 270 patients in the first group and infection diseases in 123 patients in the second group. After surgical therapy an increased urine CEA level and neoplastic cells in the urine cytology were found in 1 case which was then confirmed histopathologically. In the group with urinary infection an increased CEA level in urine, after antiphlogistic therapy, was found in 5 cases, inflammatory cells in 12 cases, pyuria in 8 cases and suspect cells were found in 6 cases in the group with urinary infection. In specimens from these cases, after electroresection, bladder cancer was diagnosed in 2, and cystitis cystica type changes in 2 cases.

Carcinoembryonic Antigen↗
PubMed1999

Urine electrolytes and the urine anion and osmolar gaps.

Urine ammonia concentration is crucial to understanding and quantifying the kidney's response to metabolic acidosis. This test is generally not performed by clinical laboratories. The urine anion gap and osmolar gaps have been proposed as surrogate measures of urine ammonia in patients with hyperchloremic acidosis. We measured ammonium and other electrolytes in the urine of patients attending our renal disease clinic who did not have severe metabolic acidosis and compared the results with those calculated by standard formulae for the anion and osmolar gaps. We found no correlation between measured ammonium values and the anion gap and attributed this lack of agreement to the presence in urine of substantial amounts of unmeasured inorganic anions, which the formula fails to consider. There was significant correlation between measured ammonium and the osmolar gap but not good agreement between the absolute values provided by the 2 methods. Solutes including sulfate and phosphate were quantified in 24-hour urine collections and showed great variability with respect to measured chloride and estimated protein catabolism. We conclude from these studies that there is no substitute for the direct determination of urine ammonium when an accurate concentration is desired.

Acid-Base Equilibrium↗