Abstracts

Abstract

Aim:To estimate the day to day variability of spot protein creatinine ratio (spotPCR). Background: Accurate measurement of proteinuria is central in the diagnosis and management of chronic kidney disease (CKD). The gold standard test, 24-hour urinary protein excretion (24hrUP), is cumbersome, subject to errors and delays in obtaining results. Spot urine PCR is a convenient alternative, however day to day variability remains undefined. Methods: 190 outpatients from a CKD clinic were prospectively studied between July 2007 and April 2010. There were 112 males and 78 females. The median age was 56 yr and median creatinine-clearance 55 mls/min. The mean 24hUP excretion was 0.69 grams/day (range = 0.07-25 grams/day). Spot urine PCRs were collected at 9am (day1) & 9am (day2) and results compared with a 24hrUP done concurrently. Urine protein and creatinine were measured on the Roche Hitachi modular analyzer using the Roche Hitachi reagent and kinetic Jaffe method respectively The variability between log-spotPCRs was determined. Spearmans correlation and Bland-Altman limits of agreement of log-spPCR vs log-24hUP and log-24hrPCR were determined respectively. Results: 158 paired results were analysed. There was no significant difference between the mean log-spotPCR1 vs. the mean log-spotPCR2 (−2.74 ± 1.31 vs. −2.73 ± 1.31, mean difference −0.01 [95% CI = −0.09 to 0.08], p = 0.89). The median log-spotPCR intraassay coefficient of variation (cv) was −6.05% There was good correlation between log-spotPCR1 and log-TP, Spearman's correlation r = 0.92. and between log-24hrPCR and log-24hUP r = 0.93. There was also good agreement between log-spotPCR1 and log-24hrPCR. Conclusion: There was no significant day to day variability between spotPCRs among this CKD clinic population. SpotPCR can be used to predict 24hrUP with a high degree of accuracy suggesting spotPCR is an appropriate test for use in the diagnosis and management of patients with kidney disease.Aim: We hypothesised that use of liposomal curcumin would provide targeted drug delivery and improve ischaemia-reperfusion injury (IRI). Background: IRI is a major cause of acute renal failure in native and transplanted kidneys. Curcumin is a lipophilic extract of turmeric with immunomodulatory and anti-oxidant properties. Methods: Fluorescent-labelled liposomes were injected into mice to assess systemic distribution and cellular uptake. Liposomes with or without curcumin were injected into male C57BL/6 mice (n = 10/group) 24 hours prior to bilateral renal ischaemia. Biochemistry, histology, apoptosis and markers of oxidative stress were measured at 4 and 24 hours. Results: Liposomes were endocytosed by renal tubular and antigen-presenting cells (APC), including CD11b+F480+macrophages, CD11c+ myeloid and PDCA-1+ plasmacytoid dendritic cells. APC exposed in vivo to liposomal curcumin, isolated and incubated ex vivo with lipopolysaccharide showed decreased NFκB nuclear translocation (immunofluorescence) compared to controls. Liposomal curcumin pre-treatment improved serum urea and...