Analysis and HPLC fractionation of urine from patients with cystic fibrosis, chronic lung diseases and normal controls

Guman-Wignot, Terese M; Kaufman, J.; Holsclaw, Douglas S.; Schmoyer, Irvin R.; Alhadeff, Jack A.

doi:10.1016/s0009-9120(89)80036-0

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…This correlation, however, indicates that the paired UCr adjustment can be used to approximate the 24-hour value relatively well within an individual but does not necessarily mean that the UCr adjusted value can be used to accurately compare concentrations across individuals. UCr has similarly been found to be a problematic normalization factor both within certain populations (2, 4, 24) and when used to compare biomarker measurements across different demographic groups with known variability in UCr (2–4, 25). Previous studies have likewise shown decreased UCr levels from 24-hour urine samples in the stable CF population compared to age-matched control patients (25–26) as well as decreased renal function with aminoglycoside use (10–13, 27–28).…”

Section: Discussionmentioning

confidence: 99%

“…UCr has similarly been found to be a problematic normalization factor both within certain populations (2, 4, 24) and when used to compare biomarker measurements across different demographic groups with known variability in UCr (2–4, 25). Previous studies have likewise shown decreased UCr levels from 24-hour urine samples in the stable CF population compared to age-matched control patients (25–26) as well as decreased renal function with aminoglycoside use (10–13, 27–28). This, in addition to the association with SG observed here, suggests that the lower UCr values in the hospitalized CF population are likely the result of lower creatinine production and impaired renal function rather than lower specimen concentration.…”

Section: Discussionmentioning

confidence: 99%

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The applicability of urinary creatinine as a method of specimen normalization in the cystic fibrosis population

Wagner

Accurso

Laguna

2010

Journal of Cystic Fibrosis

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Background Urine specimens are commonly used in biomarker research. Urinary creatinine (UCr) is often used to adjust for urine analyte concentration. We aim to explore the applicability of UCr as a normalization method in a cystic fibrosis (CF) population during hospitalization. Methods Multiple spot urine samples were collected from CF patients hospitalized for a pulmonary exacerbation. Single spot specimens were obtained from asthmatics and healthy children for comparison. The assumptions and implications from the use of UCr as a normalization factor for urinary desmosine measurements were investigated. Results UCr differed significantly across disease groups and decreased significantly over time in the CF population. Differing results were obtained when contrasting normalization by UCr with specific gravity. Conclusions UCr levels are not completely attributable to simply variations in urine concentration. Analysis of urinary biomarker measurements should be initiated with an understanding of the relative effects of the normalization process on the results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The applicability of urinary creatinine as a method of specimen normalization in the cystic fibrosis population

Wagner

Accurso

Laguna

2010

Journal of Cystic Fibrosis

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“…With continuing improvement in the treatment of pulmonary and pancreatic complications, life spans in CF will continue to increase, and NGS leading to end-stage renal disease (ESRD) could potentially evolve into a significant cause of morbidity and mortality. Proteinuria is an uncommon complication of CF [21,22]. Nevertheless, as effective strategies are developed to retard or prevent NGS, it would seem prudent to commence screening rather than waiting for the development of edema.…”

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confidence: 99%

Cystic Fibrosis – Another Cause of Nodular Glomerulosclerosis

Krous

2004

Nephron Clin Pract

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Microalbuminuria as a screening tool in cystic fibrosis-related diabetes

et al. 2005

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The improving longevity of cystic fibrosis (CF) subjects has resulted in an increased prevalence and duration of cystic fibrosis-related diabetes (CFRD). Microvascular complications were reported in CFRD. Microalbuminuria is well-established as a sensitive indicator of progression to diabetic nephropathy in non-CF diabetes, but confounding factors may make it less sensitive for CF subjects. We performed a cross-sectional study to look for the presence of microalbuminuria in samples from 40 CF subjects (34 without diabetes; CFND) attending the Exeter CF Clinic, compared with 43 nondiabetic, non-CF controls. The albumin-creatinine ratio (ACR) was raised in CF subjects both with (P < 0.001) and without (P < 0.0001) diabetes compared to controls. This reflected an increase in urinary albumin and a reduction in urinary creatinine in CF subjects. In single samples, microalbuminuria was present in 66.7%, 32.4%, and 15.4% of subjects in CFRD, CFND, and control groups. Repeat samples showed that 12% of CFND subjects and 17% of CFRD subjects met the criteria for a diagnosis of persistent microalbuminuria. In conclusion, CF subjects, even when not diabetic, have increased urinary albumin excretion due to chronic infection, and reduced urinary creatinine excretion due to low muscle mass. This results in subjects, who are not developing diabetic nephropathy, meeting the conventional criteria for microalbuminuria. We feel that further studies are required to clarify whether this measure is a useful tool to predict progression to diabetic nephropathy in subjects with CFRD.

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Analysis and HPLC fractionation of urine from patients with cystic fibrosis, chronic lung diseases and normal controls

Cited by 4 publications

References 16 publications

The applicability of urinary creatinine as a method of specimen normalization in the cystic fibrosis population

The applicability of urinary creatinine as a method of specimen normalization in the cystic fibrosis population

Cystic Fibrosis – Another Cause of Nodular Glomerulosclerosis

Microalbuminuria as a screening tool in cystic fibrosis-related diabetes

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