Creatinine Normalization of Workplace Urine Drug Tests

Price, James W.

doi:10.1097/adm.0b013e318283698c

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…However, for each drug, the post-normalization positivity rate was increased compared with the pre-normalization rates (Table 4). This finding is in agreement with the study by , which showed an increase in positivity rates for each drug examined after normalization [5].…”

Section: F I G U R E 6 Urine Specimen Collection Time and Mean Cr Concentrations (With Sd)supporting

confidence: 93%

“…Nevertheless, dilution affects the results of tests for illegal substances. Normalization of urinary drug concentrations by urine creatinine levels may augment the effectiveness of deterrent programs by mitigating volitional in vivo dilution as a means of subverting urinary drug test results [5].…”

Section: F I G U R E 6 Urine Specimen Collection Time and Mean Cr Concentrations (With Sd)mentioning

confidence: 99%

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The impact of creatinine reference value: Normalization of urinary drug concentrations

Aydoğdu

Oral

Akgür

2021

Journal of Forensic Sciences

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Many illicit drug users attempt to manipulate urine drug testing; dilution is one of the methods. In screening tests, false-negative results below the cut-off values can create positive results after creatinine normalization. This study aimed to evaluate the impact of a creatinine reference value on the normalization of the drug concentration in diluted urine. The study focused on 25 630 cases and the following information: gender, age, urine collection time, drug screening test results, creatinine concentration (CR), and confirmation analysis result. Mean CR value was 143.71 ± 83.68 mg/dl.There was a significant difference between CR and gender (p = 0.03). The mean CR for women was lower than that for men. The correlation between age and CR was not significant (r = −0.08, p = 0.00). However, after grouping the sample into age groups

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Section: F I G U R E 6 Urine Specimen Collection Time and Mean Cr Concentrations (With Sd)supporting

confidence: 93%

Section: F I G U R E 6 Urine Specimen Collection Time and Mean Cr Concentrations (With Sd)mentioning

confidence: 99%

The impact of creatinine reference value: Normalization of urinary drug concentrations

Aydoğdu

Oral

Akgür

2021

Journal of Forensic Sciences

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“…In this study, we analyzed potential urinary biomarkers of 18 DDKT recipients and revealed that the urinary levels of TG2 tended to be higher and that of SDC4 tended to be lower when IFTA was aggravated at the 6-month allograft biopsy. Urine molecule concentration depends on several biological variables such as fluid intake, body composition, in addition to hepatic and renal functions [29]. Since urinary creatinine concentration serves as an indicator of urine dilution, we measured the level of urine creatinine and mathematically adjusted for creatinine normalization of TG2 and SDC4 by dividing each concentration by the urine creatinine level.…”

Section: Discussionmentioning

confidence: 99%

“…This is an observational study at a single institution evaluating a relatively small number of patients. Furthermore, a common challenge of protein analysis of spot urine samples collected involves differences in the abundance of each protein or metabolite in biological fluids and the concentration of biological fluids is affected by various factors and by the physiological status of the patients [29]. There are several cases with missing data of urinary biomarker levels which may have possibly influenced the small cohort sample present in our study.…”

Section: Discussionmentioning

confidence: 99%

Urinary transglutaminase 2 as a potent biomarker to predict interstitial fibrosis and tubular atrophy of kidney allograft during early posttransplant period in deceased donor kidney transplantation

et al. 2019

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Purpose Transglutaminase type 2 (TG2) is an extracellular matrix crosslinking enzyme with a pivotal role in kidney fibrosis. We tested whether quantification of urinary TG2 may represent a noninvasive method to estimate the severity of kidney allograft fibrosis. Methods We prospectively collected urine specimens from 18 deceased donor kidney transplant recipients at 1-day, 7-day, 1-month, 3-month, and 6-month posttransplant. In addition, kidney allograft tissue specimens at 0-day and 6-month posttransplant were sampled to analyze the correlation of urinary TG2 and kidney allograft fibrosis. Results Thirteen recipients had increased interstitial fibrosis and tubular atrophy (IFTA) scores at the 6-month protocol biopsy (IFTA group). The mean level of urinary TG2 in the IFTA group was higher compared to that of 5 other recipients without IFTA (no IFTA group). Conversely, the mean level of urinary syndecan-4 in the IFTA group was lower than levels in patients without IFTA. In the IFTA group, double immunofluorescent staining revealed that TG2 intensity was significantly upregulated and colocalizations of TG2/heparin sulfate proteoglycan and nuclear syndecan-4 were prominent, usually around tubular structures. Conclusion Urinary TG2 in early posttransplant periods is a potent biomarker for kidney allograft inflammation or fibrosis.

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“…Urine molecule concentration depends on several biological variables such as fluid intake, body composition, hepatic function, and renal function 16. Because urinary creatinine concentration serves as an indicator of urine molecule concentration level, we measured the level of urine creatinine.…”

Section: Methodsmentioning

confidence: 99%

A composite of urinary biomarkers for differentiating between tubulointerstitial inflammation and interstitial fibrosis/tubular atrophy in kidney allografts

Wee

Lee

Choi

et al. 2018

Ann Hepatobiliary Pancreat Surg

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Backgrounds/AimsCompared with a single urinary biomarker, a composite of multiple urinary biomarkers may be more helpful for differentiating tubulointerstitial inflammation from interstitial fibrosis/tubular atrophy (IFTA) in kidney allografts.MethodsIn this cross-sectional cohort study, we collected urine samples from 115 patients with for-cause biopsy, 53 patients with stable allografts, and 50 living kidney donors. We measured the urinary levels of transglutaminase 2 (TG2), syndecan-4 (SDC4), alpha 1 microglobulin (A1M), interferon-inducible protein 10 (IP-10), interleukin 6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1).ResultsThe for-cause biopsy group showed significantly higher levels of logeTG2/Cr, logeA1M/Cr, logeIL-6/Cr, and logeMCP-1/Cr compared with other groups. In the for-cause biopsy group, logeTG2/Cr level was positively correlated with the severity of IFTA. After adjusting for age, sex, body mass index, diabetes, hypertension, cardiovascular disease, and the interval between kidney transplant and biopsy, TG2 and the interval between transplant and biopsy were significantly correlated variables for the severity of IFTA. Regarding tubulointerstitial inflammation, Body mass index, TG2, SDC4, and IP-10 were positively-correlated variables, and MCP-1 and the interval between transplant and biopsy were negatively-correlated variables.ConclusionsOur results show that post-transplant urinary levels of TG2, SDC4, MCP-1 and IP-10 may be a useful biomarker for tubulointerstitial inflammation and IFTA.

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Creatinine Normalization of Workplace Urine Drug Tests

Abstract: This result indicates that specimen dilution does affect the number of laboratory-positive results confirmed.

Cited by 12 publications

References 20 publications

The impact of creatinine reference value: Normalization of urinary drug concentrations

The impact of creatinine reference value: Normalization of urinary drug concentrations

Urinary transglutaminase 2 as a potent biomarker to predict interstitial fibrosis and tubular atrophy of kidney allograft during early posttransplant period in deceased donor kidney transplantation

A composite of urinary biomarkers for differentiating between tubulointerstitial inflammation and interstitial fibrosis/tubular atrophy in kidney allografts

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