Microalbuminuria, Indicated by Total versus Immunoreactive Urinary Albumins, in Acute Ischemic Stroke Patients.
Summary of "Microalbuminuria, Indicated by Total versus Immunoreactive Urinary Albumins, in Acute Ischemic Stroke Patients."
Microalbuminuria, assessed by measuring immunoreactive albumin, is common in patients with cerebrovascular disease and is associated with increased risk of stroke. Total urinary albumin (t-uAlb) comprises both immunoreactive albumin (ir-uAlb) and nonimmunoreactive albumin (nir-uAlb). We hypothesized that t-uAlb is a more sensitive indicator of microalbuminuria than ir-uAlb, and that measurement of t-uAlb will increase the prevalence of microalbuminuria in ischemic stroke patients compared with measurement of ir-uAlb and will show a stronger correlation with the severity of stroke and oxidative stress. In urine samples from 98 patients with ischemic stroke, the albumin-to-creatinine ratios t-uAlb/uCreat and ir-uAlb/uCreat were measured by high-performance liquid chromatography (HPLC) and immunoturbidimetry (IT), and the nir-uAlb/uCreat ratio was calculated. Urinary ortho-tyrosine (o-Tyr/uCreat), an indicator of oxidative stress, was measured by HPLC. The severity of stroke was scored based on the National Institutes of Health Stroke Scale (NIHSS). The prevalence of microalbuminuria detected by HPLC was significantly higher than that detetcted by IT (66.3 vs 36.7%). Although all forms of albumin showed significant correlation with stroke severity (t-uAlb: r = 0.24, P < .05 ir-uAlb: r = 0.25, P < .05 nir-uAlb: r = 0.29, P < .05), only nir-uAlb was found to be an independent predictor of stroke severity (B = 0.20, beta = 0.35, P < .05). In addition, t-uAlb/uCreat and nir-uAlb/uCreat had a significant correlation with o-Tyr/uCreat (r = 0.336, P < .05 and r = 0.358, P < .05 respectively), whereas ir-uAlb/uCreat did not (r = 0.22, P > .05). Our data suggest that in acute ischemic stroke patients, t-uAlb is a more sensitive indicator of microalbuminuria than the presently used ir-uAlb. Future studies should aim to elucidate the underlying mechanisms for the relationship among urinary albumins and cerebrovascular diseases and the role of urinary albumins in risk stratification for stroke.
Department of Physiology, New York Medical College, Valhalla, New York; Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary.
This article was published in the following journal.
Name: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20813547
- DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2010.03.002
We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspiss...
Background: Recent studies have shown that urinary neutrophil gelatinase-associated lipocalin (NGAL) is rapidly up-regulated early after murine renal injury, and in patients after cardiac surgery or p...
Microalbuminuria precedes the onset of diabetic nephropathy in insulin-dependent diabetes mellitus (IDDM) pediatric patients. Its prevention is among the most important challenges in managing IDDM. We...
ABSTRACT The aim of this study was to determine 8-hydroxydeoxyguanosine (8-OH-dG) levels in trichloroethylene (TCE)-exposed workers. Oxidative stress biomarkers and biochemical parameters were monitor...
To determine whether acute urinary toxicity rates improve with the overall experience of a large prostate brachytherapy program.
The purpose of this study is to compare if the combination of valsartan 320 mg/lisinopril 20 mg versus the monotherapies of lisinopril 40 mg or valsartan 320 mg will result in a greater de...
This study was designed to determine whether COREG MR is more effective than TOPROL-XL in reducing microalbuminuria in type 2 diabetic or non-diabetic patients with high blood pressure and...
This research project will look at the relationship between baseline variables, and the new onset of microalbuminuria and the response to treatment with an angiotensin receptor blocker, lo...
The primary objective of the study is to investigate if 14 days of treatment with Alfuzosin compared to placebo, will increase the number of patients with satisfying spontaneous voiding af...
The purpose of this trial are to evaluate the reduction of urinary albumin excretion by an angiotensin receptor blocker (ARB), valsartan, in comparison with a calcium channel blocker (CCB)...
Medical and Biotech [MESH] Definitions
A compound formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids.
A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596)
Histochemical localization of immunoreactive substances using labeled antibodies as reagents.
An artifical implanted device, usually in the form of an inflatable silicone cuff, inserted in or around the bladder neck in the surgical treatment of urinary incontinence caused by sphincter weakness. Often it is placed around the bulbous urethra in adult males. The artificial urinary sphincter is considered an alternative to urinary diversion.
Immunologic method used for detecting or quantifying immunoreactive substances. The substance is identified by first immobilizing it by blotting onto a membrane and then tagging it with labeled antibodies.