Related Experiment Video
Updated: Mar 21, 2026
09:16
Assessment of Kidney Function in Mouse Models of Glomerular Disease
Published on: June 30, 2018
18.8K
Measuring urine albumin and total protein.
W Greg Miller1, Jesse C Seegmiller2, Lorin M Bachmann1
1Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA.
Summary
Standardizing urine albumin (UA) measurements is nearing completion with new reference materials. However, standardizing urine total protein (UTP) measurements remains challenging due to diverse analytical methods used in in-vitro diagnostic medical devices.
Area of Science:
- Clinical Chemistry
- Laboratory Medicine
- Biomarker Standardization
Background:
- Urine albumin (UA) and total protein (UTP) are vital biomarkers for assessing kidney disease.
- Current clinical guidelines rely on fixed thresholds for UA and UTP, but results vary significantly across different in-vitro diagnostic medical devices (IVD-MDs).
- Previous studies show substantial discrepancies (37-45% for UA, ~50% for UTP) in measurements from various IVD-MDs, potentially leading to misdiagnosis and incorrect medical decisions.
Purpose of the Study:
- To address the lack of standardization in UA and UTP measurements from IVD-MDs.
- To highlight the development of higher-order reference materials and procedures for UA standardization.
- To explain the challenges and lack of current plans for UTP standardization.
Main Methods:
- Development of higher-order certified reference materials (CRMs) and reference measurement procedures (RMPs) for UA.
- Utilizing external quality assurance programs to assess UTP measurement variability.
- Analysis of calibration schemes and analytical methods employed by IVD-MDs for UA and UTP.
Main Results:
- A standardization program has successfully developed higher-order CRMs and RMPs for UA, paving the way for standardized measurements.
- Transition to the new UA reference system by IVD-MD manufacturers is anticipated to improve result agreement.
- Significant inter-device variability persists for UTP, with no clear path toward standardization due to diverse chemical reactions and disease-dependent protein variations.
Conclusions:
- Standardization of UA measurements is achievable and expected soon through the implementation of new reference materials and procedures.
- Standardization of UTP measurements faces significant technical hurdles, making current efforts to improve inter-device agreement unlikely.
- The lack of standardized UTP measurements poses a continued risk for accurate kidney disease assessment and patient management.
Related Concept Videos
01:29Urine Studies I: Urinalysis
2.1K
Urinalysis is a widely used diagnostic test that analyzes urine's physical, chemical, and microscopic characteristics. Healthcare providers use it to detect and monitor various health conditions, including renal disease, urinary tract infections (UTIs), diabetes, and metabolic or systemic disorders.Components of UrinalysisUrinalysis consists of three primary components: physical, chemical, and microscopic examination. Each provides unique insights into the urine sample and, by extension, the...
2.1K
01:26Nephrotic Syndrome II : Assessment and Medical Management
304
IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
304
01:24Serum Studies: Renal Function Tests
593
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
593
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
94
The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
94
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
337
In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance...
337
01:23Renal Clearance
3.2K
The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
3.2K