Urinary amylase / urinary creatinine ratio (uAm/uCr) - a less-invasive parameter for management of hyperamylasemia

Abstract

BackgroundThe serum level of amylase (sAm) is commonly used as a biochemical marker for diagnosis and management of pancreatic disorders. However, the use of the urine level of amylase (uAm) is limited in practice, because the diagnostic ability of uAm is inferior to that of sAm. In the present study, the possible concordance of uAm-rerated parameters with sAm was investigated, and evaluate the usefulness of uAm for management of hyperamylasemia.MethodsFrom June 1995 to October 2009, 804 samples of both urine and blood were collected from 128 patients in order to measure the serum level of amylase (sAm) and the urine level of amylase (uAm) and creatinine (uCr). Concordance of parameters using uAm compared to sAm was assessed. Parameters used were uAm, amylase creatinine clearance ratio (ACCR), and the ratio of uAm to uCr (uAm/uCr).ResultsuAm/uCr had the best correlation with sAm (r = 0.779, p < 0.001) compared to uAm (r = 0.620, p < 0.001) and to ACCR (r = 0.374, p < 0.001), when sAm was over the standard level. The area under the receiver operating characteristic curve of uAm/uCr (0.884) was significantly higher than that of uAm (0.766) and of ACCR (0.666) (p < 0.001 for each). The cutoff value of uAm/uCr was 569.8, with a sensitivity of 81.0% and a specificity of 83.1%.ConclusionsThe uAm/uCr ratio correlated with sAm, and may be an alternative to sAm for prediction of hyperamylasemia. Use of urine samples results in a decreased need for blood sampling, which is especially beneficial in pediatric patients.

Clinical significance of Urinary Amylase in Acute Pancreatitis

“…With regards to correlation analysis, urinary amylase had the best correlation with serum amylase at admission (p<0.001). In 273 samples (34.0% of all samples), when serum amylase was over the standard level, urinary amylase also had the best correlation with serum amylase (p < 0.001) [37]. The results are in accordance with the indings of the present study.…”

“…The principles of conservative management followed in each case were adequate analgesia, correction of luid and electrolytes imbalance, complete GI tract rest and Antibiotics. Our study is consistent with the indings of Keita Terui et al, wherein the authors observed that overall conservative management is favorable over surgical management [37]. Another study done by Prakash V. Chauhan et al, wherein 38 (76%) patients were conservatively managed and only 12 (24%) were operated upon [33].…”

“…In a study done Nehal Naik et al, most (92%) of the patient's serum amylase was 3 fold above normal value which is consistent with the indings of the present study [35]. Serum amylase level was again raised in 76.3% of patients studied by Keita Terui et al [37]. Serum amylase level is elevated in all patients during the initial period of acute pancreatitis in a series of 352 patients with acute pancreatitis admitted to clinic of digestive surgery, Geneva University hospital revealed that hyperamylasemia is seen in 81% of patients [33].…”

Urinary amylase levels in the diagnosis of acute pancreatitis: a prospective case control study

“…In a study done Naik et al most (92%) of the patient's serum amylase was 3 fold above normal value which is consistent with the findings of the present study. 12 Serum amylase level was again raised in 76.3% of patients studied by Terui et al 15 Similar study done by MD Wani et al, found that comparing urinary amylase levels with serum amylase level at admission in the studied subjects, it was observed that 2 patients (18.2%) had <150 U/L, 0 (0%) 150-450 U/L and 1 (0.8%) >450 U/L serum amylase levels were having <400 U/L urinary amylase levels. 2 (18.2%), 9 (47.4%) patients and 23 (19.2%) with serum amylase levels of <150, 150-450 and >450 UL were observed to have 400-1000 U/L urinary amylase levels.…”

Quantitative TLC-Image Analysis of Urinary Creatinine Using Iodine Staining and RGB Values

“…Creatinine is colorless and is secreted in urine at an easily detectable level. It is a common biomarker of renal function and has been used as an indicator of urine tampering or dilution in routine drug tests as well as an internal standard for analysis of other substances such as by the analyte-creatinine ratio (12,13). In addition, urine collection is noninvasive and urine exhibits complex matrices which will help demonstrate the performance of the proposed TLC-image analysis method.…”