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Тезисы докладов

Albuminuria below the detection limit of the traditional protein teststrip has been introduced as early marker of diabetic nephropathy, nephrosclerosis and cardiac risc monitor. Positive cases have been differentiated from primary glomerular, tubular and postrenal causes of albuminuria. This is possible by simultaneous measurement other urine proteins like alpha1-microglobulin, IgG and alpha 2 –macroglobulin.

Urine albumin, IgG(glomerular Marker), alpha1-microglobulin (tubular marker) and alpha 2 –macroglobulin (postrenal marker) can be measured nephelometrically and turbidimetrically in routine analysers. Whgen comparing 297 patients with histologically proven primary glomerulopathies and tubulopathies the tubular marker allowed to separate tubulointerstitial nephropathies from primary as well as secondary glomerular disorders. In diabetic or hypertensive nephropathies (beginning glomerulosclerosis) the tubular marker was significantly higher at similar albuminuria. Postrenal albuminuria was paralleld by a positive blood test strip. This could be separated from renal causes of hematuria by measuring Х alpha 2 –macroglobulin and IgG, whose pattern characterised postrenal bleeding when albulin excretion exceeded 100 mg/L. By comparing the urine protein pattern, this strategy allows to separate primary from secondary and postrenal causes of albuminuria from a singe spot urine sample.

Guder WG, Ivandic M, Hofmann W. Physiopathology of proteinurias and laboratory diagnostic strategy based on single protein analysis. Clin Chem Lab Med 1998;36:935-9.

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