Predictive value of random sample urine bile acids corrected by creatinine in liver disease

Abstract

Bile acids, in a random sample of urine, discriminated normal controls from liver disease, with a probability similar to fasting plasma bile acids (p less than 0.01 and p less than 0.001, depending on the analytical technique). A high degree of correlation between urinary and plasma bile acids (up to r = 0.93) was achieved only when the urine flow was corrected by using a urinary bile acids/creatinine ratio but not with urinary bile acids as simple volume concentration. These findings originated from 10 patients with severe liver disease and 10 with mild liver disease, all biopsy-confirmed, compared with controls. In 24 normal controls and 24 histologically confirmed compensated liver disease, the predictive value of urinary bile acids/creatinine equaled or exceeded fasting plasma bile acids and routine liver tests. In a patient recovering from subacute hepatic necrosis, the urinary bile acids/creatinine closely resembled changes in plasma bile acids and in the routine liver tests. When sulfated urinary bile acids were included, the discrimination between liver disease and controls did not improve. Gallbladder contraction induced by parenteral analogs of cholecystokinin did not change urinary bile acids/creatinine, despite a significant increase in the plasma bile acids. Collection of fasting urine is thus not necessary. Urinary bile acids/creatinine in 12 subjects with renal insufficiency and moderate impairment of creatinine clearance was not different from controls. The weight/height index did not affect this urinary test: there was no significant correlation between the two. Available radioimmunoassays for plasma bile acids can be easily adapted for urine.(ABSTRACT TRUNCATED AT 250 WORDS)

Prognostic roles of tetrahydroxy bile acids in infantile intrahepatic cholestasis

“…First, although urinary BA analysis is not performed in the laboratories of most hospitals, it should be included in routine investigational assays of chronic cholestatic patients, as expanded lists of phenotypic and metabolic defects associated with IEBAM have been recently reported (30). In clinical practice, urine sample collection is easy to perform, the data are not affected by fasting conditions after correction by Cre, and analyses have low variability and high stability compared with analyses of serum BAs levels (31,32).…”

NMR-based metabonomic approaches for evaluating physiological influences on biofluid composition

“…11 Similarly, specific markers of liver injury have been proposed, for example, urinary levels of bile acids have been proposed as non-invasive markers of minor liver dysfunction which are as sensitive as serum measurements. 32 Elevations in the levels of urinary taurine have also been associated with liver dysfunction. 27,33 However, many endogenous metabolites, such as taurine, fluctuate in concentration as a result of normal physiological variation.…”

Efficacy of urine bile acid as a non-invasive indicator of liver damage in rats

“…Urine bile acids (UBA) have been detected in patients with hepatic disease since the 1950s (Rudman and Kendall, 1957; Makino et al et al., 1976;Almé et al, 1977;Simko et al, 1987;Batta et al, 1989; Shoda et al acids has been carried out mainly by gas or liquid chromatography -mass spectrometry (GC-MS, LC-MS) in recent studies. GC-MS and LC-MS can identify various structurally different bile acids precisely, and alteration of the composition of UBA can be analyzed.…”

“…Normalized UBA values were expressed in micromoles per gram of creat--atinine, because this method was generally used in order to normalize the amount of urinary compounds, and several studies revealed that this normalization was suitable for UBA analysis in human, cats, and dogs (Simko et al, 1987;Trainor et al, 2003;Balkman et al, 2003).…”

“…The blood concentration -tions, but is increased in the case of a disorder in the liver or biliary tract (Dawson, 2002). Therefore, the serum bile acid level is a marker of liver disease, although it is not widely used as a routine screening test.Urine bile acids (UBA) have been detected in patients with hepatic disease since the 1950s (Rudman and Kendall, 1957; Makino et al et al., 1976;Almé et al, 1977;Simko et al, 1987;Batta et al, 1989; Shoda et al acids has been carried out mainly by gas or liquid chromatography -mass spectrometry (GC-MS, LC-MS) in recent studies. GC-MS and LC-MS can identify various structurally different bile acids precisely, and alteration of the composition of UBA can be analyzed.…”