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A diagnostic programme for quantitative analysis of proteinuria.

W Hofmann1, W G Guder

  • 1Institut für Klinische Chemie, Städtisches Krankenhaus München Bogenhausen.

Journal of Clinical Chemistry and Clinical Biochemistry. Zeitschrift Fur Klinische Chemie Und Klinische Biochemie
|September 1, 1989
PubMed
Summary

New quantitative methods accurately detect and differentiate proteinuria using the Kone Specific Analyser. These methods improve detection rates compared to standard tests, aiding in identifying glomerular and tubular proteinuria.

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Area of Science:

  • Clinical Chemistry
  • Nephrology
  • Analytical Biochemistry

Background:

  • Accurate quantification and differentiation of proteinuria are crucial for diagnosing kidney diseases.
  • Existing methods may lack the sensitivity or specificity to detect all forms of proteinuria.
  • The Kone Specific Analyser offers potential for advanced urine analysis.

Purpose of the Study:

  • To adapt and validate quantitative methods for recognizing, quantifying, and differentiating various forms of proteinuria using the Kone Specific Analyser.
  • To assess the analytical performance (precision, accuracy, linearity) of these new methods.
  • To establish reference ranges and evaluate the clinical utility of the adapted methods.

Main Methods:

  • Quantitative methods for total protein, IgG, albumin, alpha 1-microglobulin (turbidimetry), N-acetyl-beta-D-glucosaminidase activity, and creatinine (photometry) were adapted for the Kone Specific Analyser.

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  • Analytical validation included within- and between-run precision, accuracy, linearity, and comparison with reference methods (nephelometry, radial immunodiffusion, biuret).
  • Analyte stability in urine, intra- and inter-individual variability, and comparison of spot urine (second morning) with 24-hour urine were assessed.
  • Main Results:

    • Turbidimetric methods showed good agreement with nephelometric procedures and high correlation (r > 0.98) with radial immunodiffusion.
    • Methods demonstrated good linearity and low detection limits, enabling quantification across a wide range of analyte concentrations.
    • Quantification per mol creatinine reduced variability; spot urine results correlated well with 24-hour urine, except for alpha 1-microglobulin.
    • Application to unselected urines revealed a threefold increase in abnormal results compared to routine test strips, identifying glomerular and tubular proteinuria.

    Conclusions:

    • Quantitative turbidimetric and photometric methods adapted for the Kone Specific Analyser are reliable for proteinuria assessment.
    • These methods enhance the detection of various proteinuria types, offering improved diagnostic capability over standard dipstick tests.
    • Measuring albumin or N-acetyl-beta-D-glucosaminidase excretion is sufficient to detect additional cases of proteinuria.