Reference Ranges and Methodological Aspects in the
Urinary Measuring of Lysozyme, Malate-Dehydrogenase,
γ-Glutamyltransferase and a-Glucosidase

Amodio, Piero; Bazzerla, G.; Malatesta, Renzo; Gatta, Angelo

doi:10.1159/000469436

Cited by 9 publications

(4 citation statements)

References 20 publications

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“…27 Urine AGL and GGT as well as plasma and urine LYS measurements were performed by methods previously described. 28 PRA and plasma levels of PA, ADH, and atrial natriuretic peptide were evaluated by means of radioimmunoassay (RIA) with methods described in detail elsewhere. 29 The serum concentration of NOx was measured by means of a colorimetric assay kit based on a simple two-step process as described previously.…”

Section: Methodsmentioning

confidence: 99%

Reversal of type 1 hepatorenal syndrome with the administration of midodrine and octreotide

et al. 1999

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The aim of the study was to verify the effects of the administration of an inhibitor of the release of endogenous vasodilators together with a vasoconstrictor agent in patients with hepatorenal syndrome (HRS). This new medical perspective was compared with a traditional medical approach for HRS, such as the infusion of nonpressor doses of dopamine to produce renal vasodilation. Thirteen patients with type 1 HRS were enrolled in the study. Five of them were treated with the oral administration of midodrine and the parenteral administration of octreotide. In addition, the patients received 50 to 100 mL of 20% human albumin solution daily for 20 days. Midodrine and octreotide were dosed to obtain a stable increase of at least 15 mm Hg of mean arterial pressure. Eight patients were treated with the intravenous administration of nonpressor doses of dopamine (2-4 g/kg/min) and the same daily amount of albumin. After 20 days of treatment with midodrine and octreotide, an impressive improvement in renal plasma flow (RPF), glomerular filtration rate, and urinary sodium excretion was observed in patients. This was accompanied by a significant reduction in plasma renin activity, plasma vasopressin, and plasma glucagon. No side effects were observed. Three patients were discharged from the hospital. One of them successfully underwent liver transplantation. One of the two remaining patients is still alive after 472 days with a preserved renal function, and the other died from terminal liver failure after 76 days. One of the two patients who were not discharged from the hospital successfully underwent liver transplantation, and the other died from pneumonia after 29 days. Seven out of eight patients who were treated with dopamine experienced a progressive deterioration in renal function and died during the first 12 days. Only one patient recovered renal function and underwent liver transplantation. In conclusion, the long-term administration of midodrine and octreotide seems to be an effective and safe treatment of type 1 HRS in patients with cirrhosis. (HEPATOLOGY 1999;29:1690-1697.)Hepatorenal syndrome (HRS) occurs in 18% of cirrhotic patients with ascites. HRS is characterized by intense vasoconstriction, low glomerular filtration rate (GFR), preserved tubular function, and normal renal histology. 1 The diagnostic criteria of HRS have been recently reviewed, and HRS has been classified on a clinical basis into two different types: type 1 characterized by rapidly progressive renal function impairment and type 2 in which renal failure does not have a rapidly progressive course. 2 From a pathophysiological point of view HRS is considered to be the extreme expression of a reduced effective circulating volume because of arteriolar vasodilation, particularly in the splanchnic area. 3 Consequently, the extreme increase in the activity of both renin-angiotensin and sympathetic nervous system as well as the elevated circulating levels of endothelin are the most likely cause of HRS. [4][5][6][7][8][9]

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Section: Methodsmentioning

confidence: 99%

Reversal of type 1 hepatorenal syndrome with the administration of midodrine and octreotide

et al. 1999

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“…l, point 2) are essentiaily influenced by diuresis (12, 25 -27 indirect and a direct effect on these parameters. A high urine flow rate does not lead to a similar increased Output of all enzymes (8,26). It occurs because the urine volume varies over a wide ränge, so that the measured enzyme concentration is more or less concentrated or diluted.…”

Section: Influence Of Diuresis On Urinary Enzyme Excretionmentioning

confidence: 99%

“…It has been demonstrated that the kidney enzyme content of urine decreases m renal diseases (33 -35). Thus, fractional excretion has been suggested s a well-founded reference basis for expressing enzymuria, taking irj^o account the functioning renal tissue (8). The following equations show that this reference basis also takes account of the serum creatinine value: They emphasized that the fractional excretion was the best way to express urinary enzyme excretion both for "tubular" (characterized by low-molecular mass proteins like lysozyme from serum) and "parenchymatous" enzymuria (characterized by enzymes from renal tissue).…”

Section: Fractional Excretion Rate Of Urinary Enzymesmentioning

confidence: 99%

“…It has been reported that the data for enzyme excretions in adults do not become more homogeneous when related to the body surface (8,36) or body mass (36), whereas others have reported that this method reduces the variability of urinary enzyme excretion in children (37). The results observed in children are reflected in experiments with fast growing animals (e. g., rats), in which the reference of urinary enzyme excretion to body weight seems to be imperative (38).…”

Section: Relation Of Urinary Enzyme Excretion To Body Weight and Bodymentioning

confidence: 99%

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Review

1991

Clinical Chemistry and Laboratory Medicine

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Different methods and reference bases for characterizing the excretion of urinary enzymes (relation to volume, time, creatinine, specific gravity, osmolality and fractional excretion) are reviewed with regard to their advantages and disadvantages when using urinary enzyme excretion äs a diagnostic tool. The problems of timed and untimed urine samples for the analysis of urinary enzyme excretion and the influence of diuresis on the quantity and composition of enzymes excreted are discussed. The use of the second morning urine äs a random urine sample, and determination of the relation of enzyme activity to urinary creatinine (enzyme/ creatinine ratio; enzyme/creatinine index) represent a satisfactory compromise for the characterization of urinary enzyme excretion. The calculation of enzyme excretion per unit time or other modes of expression should be used only in special cases.

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The Serum Gamma-glutamyltransferase Isoenzyme System and its Diagnostic Role in Hepatobiliary Diseases

Sacchetti

Castaldo

Salvatore

1989

Progress in Clinical Biochemistry and Medicine

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Reference Ranges and Methodological Aspects in the Urinary Measuring of Lysozyme, Malate-Dehydrogenase, γ-Glutamyltransferase and a-Glucosidase

Cited by 9 publications

References 20 publications

Reversal of type 1 hepatorenal syndrome with the administration of midodrine and octreotide

Reversal of type 1 hepatorenal syndrome with the administration of midodrine and octreotide

Review

The Serum Gamma-glutamyltransferase Isoenzyme System and its Diagnostic Role in Hepatobiliary Diseases

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