The Plasma Phenolsulfonphthalein Index (PSPI) of Renal Function: II. Correlation with Other Parameters of Renal Function and Indications for Use

The plasma phenolsulfonphthalein index (PSPI) was determined in 175 subjects and was compared with levels of blood urea nitrogen (BUN) and serum creatinine, 15-minute urinary excretion of PSP, and clearance of creatinine, PAH and inulin. Statistical analyses indicate that the PSPI measures the same function as the 15-minute urine test when PSP is administered in a dosage of 1 mg./kg. body weight; and that, although the index cannot be used as a precise substitute for PAH clearance, it is equally repeatable and no greater error is associated with its measurement. The PSPI has been found of most value when complete, accurately timed urine collections are unobtainable because of urological abnormality or inability of the patient to co-operate.     

Patterns of urine flow and electrolyte excretion in healthy elderly people.

Twenty four young (mean age 29.2 years, range 25-35) and 21 elderly (mean age 66.5, range 60-80) healthy subjects collected their urine in timed aliquots over 24 hours. The elderly subjects had been selected for their fitness by clinical and laboratory examinations and all lived independently at home. Sodium and potassium excretions were reduced in the elderly subjects compared with the young subjects, potassium excretion considerably so. This was despite similar 24 hour urine volumes and total solute excretion by both groups. The ratios of rates of excretion of water, electrolytes, and solutes during the night to the rates of excretion during the day were found to be higher in the elderly than the young subjects. Reduced day to night ratios of urinary excretion may be partly responsible for complaints of nocturia and sleep disturbance in elderly people.     

Protein concentration in urine of normal owl monkeys.

The excretion of urinary protein was evaluated in 62 owl monkeys using timed urine collections. The ratio of urine protein to urine creatinine concentrations (Up/c) was determined for each monkey. Linear regression analysis was used to calculate the correlation between that ratio and urine protein (mg/dl) and 24-hour urinary protein loss (mg/kg). The coefficient of determination for Up/c to urine protein and 24-hour urinary protein loss was significant (P less than or equal to 0.0001). Determination of the Up/c in a urine specimen was found to be an acceptable diagnostic technique for detection and quantitative estimation of proteinuria.     

Effect of difructose anhydride III on calcium absorption in humans

The effects of difructose anhydride III (DFAIII) on stimulating calcium absorption was investigated in humans. We studied changes in the time-course of characteristics urinary calcium excretion in 12 healthy men given 0.3, 1.0 or 3.0 g of DFAIII and 300 mg of calcium as calcium carbonate. In addition, urinary excretion and urine concentrations of creatinine and deoxypyridinoline were determined. Urine calcium excretion every 2 hours after the intake were higher over than that of the control subjects. The total amount of urinary calcium excretion for 10 hours was significantly greates in the subjects given 1.0 g or 3.0 g of DFAIII than that of the control subjects. However, there were no differences in the urine concentrations of creatinine and deoxypyridinoline between the subjects given DFAIII and the control subjects. These findings suggests that low dose of DFAIII had a stimulating effect on calcium absorption in humans.     

Microalbuminuria: associations with height and sex in non-diabetic subjects.

OBJECTIVES--To study the association(s) between microalbuminuria and cardiovascular risk factors in non-diabetic subjects. DESIGN--Patients aged 40-75 years were randomly selected from a general practice list and invited to participate. SETTING--Health centre in inner city London. SUBJECTS--Of those invited, 1046 out of 1671 (62.6%) attended. Subjects were excluded for the following reasons: not being white (44); urinary albumin excretion rate > 200 micrograms/min (3); having a urinary infection (5); taking penicillamine or angiotensin converting enzyme inhibitors (7); older than 75 (2); having diabetes (25); missing data on glucose concentration (1). MAIN OUTCOME MEASURES--Glucose tolerance test results, albumin excretion rate from overnight and timed morning collections of urine; blood pressure; height. RESULTS--Mean albumin excretion rate was significantly lower in women than men (mean ratio 0.8, 95% confidence interval (0.69 to 0.91)). Mean albumin excretion rate was significantly associated with age, blood pressure, and blood glucose concentration (fasting, 1 hour, and 2 hour) in men and inversely with height. Men who had microalbuminuria in both samples were significantly shorter (by 5 cm (1.3 to 9.3 cm)) than those who had no microalbuminuria in either sample when age was taken into account. In the case of women only systolic pressure was significantly associated with albumin excretion rate. CONCLUSIONS--Microalbuminuria and short stature in men are associated. Cardiovascular risk has been associated with both of these factors and with lower birth weight. The inverse association of microalbuminuria with height is compatible with the suggestion that factors operating in utero or early childhood are implicated in cardiovascular disease. The higher prevalence of microalbuminuria in men compared with women may indicate that sex differences in cardiovascular risk are reflected in differences in albumin excretion rate.     

Effects of tilting and volume loading on plasma levels and urinary excretion of relaxin, NT-pro-ANP, and NT-pro-BNP in male volunteers.

The polypeptide relaxin (RLX) has been suggested to play a role in cardiorenal integration and to be related to the natriuretic peptide system. We hence examined the effects of variations in thoracic blood volume and intravenous volume loading on plasma and urinary RLX levels and associated changes in natriuretic peptide levels in healthy men. Two groups of eight subjects were randomly tilted into a 15 degrees feet-down or a 15 degrees head-down position. Ten volunteers were crossover subjected to an infusion of 15 ml/kg of 0.9% NaCl (over 60 min) or control during an observation period of 10 h. Blood and urine were sampled at timed intervals. RLX, NH(2)-terminal prohormones of atrial natriuretic peptide (NT-pro-ANP), and NH(2)-terminal prohormones of brain natriuretic peptide (NT-pro-BNP) were determined by enzyme, radio-, and electrochemoluminescence immunoassays, respectively. NT-pro-ANP levels (in percentage of baseline levels) were higher (P < 0.05) during the head-down (124 +/- 13%) than during the feet-down position (82 +/- 6%). NT-pro-BNP and RLX were not affected by tilting. Volume loading induced a short-lasting increase in plasma NT-pro-ANP, a delayed increase in plasma NT-pro-BNP, had no effect on plasma RLX, and induced a parallel increase in urine flow, renal excretion of sodium, RLX, and NT-pro-BNP. It is concluded that variations in thoracic blood volume in healthy men are not associated with variations in plasma RLX. Increased urinary RLX and NT-pro-BNP excretion during volume loading suggest renal production and a possible role of kidney-derived RLX and brain natriuretic peptide in sodium homeostasis in men.     

Effect of daily hyperhydration on fluid-electrolyte changes in endurance-trained volunteers during prolonged restriction of muscular activity

The aim of this investigation was to evaluate the effect of a daily intake of fluid and salt supplementation on fluid and electrolyte losses in endurance-trained volunteers during prolonged restriction of muscular activity (hypokinesia). The studies were performed on 30 long-distance runners aged 23–26 who had a peak oxygen uptake of 65.5 mL/kg/min and had taken 13.8 km/d on average prior to their participation in the study. The volunteers were divided into three groups: The volunteers in the first group were placed under normal ambulatory conditions (control subjects), the second group of volunteers subjected to hypokinesia alone (hypokinetic subjects), and the third group of volunteers was submitted to HK and consumed daily 0.1 g sodium chloride (NaCl)/kg body wt and 26 mL water/kg body wt (hyperhydrated subjects). The second and third group of volunteers were kept under an average of 2.7 km/d for 364 d. During the pre-experimental period of 60 d and during the experimental period of 364 d sodium, potassium, calcium, and magnesium in urine and plasma were determined. Blood was also assayed for osmolality, hemoglobin, hematocrit, plasma volume, plasma renin activity and plasma aldosterone. Mean arterial blood pressure was also determined. In the hyperhydrated volunteers plasma volume and arterial blood pressure increased, whereas plasma osmolality, plasma renin activity, plasma aldosterone, hematocrit, hemoglobin concentration, and urinary excretion and concentrations of electrolytes in plasma decreased. In the hypokinetic volunteers, plasma volume and arterial blood pressure decreased significantly, whereas hematocrit values, hemoglobin concenfration, plasma osmolality, plasma renin activity, plasma aldosterone, and electrolytes in urine and plasma increased significantly during the experimental period. It was concluded that chronic hyperhydration may be used in minimizing fluid and electrolyte losses in endurance-trained volunteers during prolonged restriction of muscular activity.     

Urinary zinc excretion and zinc status of patients with Β-thalassemia major

In this study, zinc status and urinary zinc excretion with and without desferrioxamine (DFO) infusion and the relationship between urinary zinc excretion and renal tubular dysfunction in thalassemia major (TM) patients were investigated. Forty TM patients were given four DFO infusions on alternate days over a 1-wk period prior to the transfusion. On each day that DFO was given, a 24-h urine collection initiated. DFO was omitted for 1-wk before the following transfusion and during the period four 24-h urine collections were performed. Twenty healthy children provided 24-h urine collection as controls. Blood samples were taken on each of two consecutive transfusion days of the patients and from the controls. Urinary zinc excretion was measured and plasma and red blood cell (RBC) zinc analysis were performed by inductively coupled plasma-atomic emission spectrophotometry. UrinaryN-acetyl-Β-D-glucosaminidase (NAG) activity and creatinine were determined in morning urine specimens. The mean plasma zinc concentration was significantly lower in the patients not given DFO compared to the values of the patients given DFO and the control group. The mean RBC zinc concentration (Μmol/g Hb) in the patients (with and without DFO) and the control group were similar. Urinary zinc excretion was significantly higher in the patients receiving DFO compared to the control group, whereas urinary zinc excretion in the patients not given DFO was not different from the controls. Urinary NAG indices (U/g Cr) were significantly higher in the patients compared to controls. Urinary zinc excretion was correlated with the urinary NAG indices.     

Renal clearance and excretion of endogenous substances in the owl monkey

The clearance and excretion of creatinine, calcium, phosphorus, sodium, and potassium by the kidney was evaluated in 62 owl monkeys using timed urine collections and quantitative urinalyses. The endogenous clearance of creatinine was determined for each monkey. Urinary electrolyte excretion and fractional electrolyte excretions (FE) were measured. Linear regression analysis was used to calculate the correlation between urinary excretion and FE for each electrolyte. The coefficient of determination for each analyte was significant (P ? .0001). Determination of FE was found to be an appropriate indicator of the renal handling of electrolytes and, when viewed in conjunction with urinalysis and other serum parameters, an aid in evaluating renal function in the owl monkey. © 1992 Wiley-Liss, Inc.     

Molybdenum metabolism: Stable isotope studies in infancy

The essential trace element molybdenum (Mo) is bound to and required for the function of molybdoenzymes, e.g. sulfite and xanthine oxidase. Dietary recommendations for early infancy are based on limited knowledge about its metabolism. 100Mo was used as an extrinsic tag to study the absorption and kinetics of excretion in infancy. 10 infants with a gestational age of 35 (30-39) weeks, a birth weight of 2.0 (0.9-2.3) kg and a post-natal age of 20 (10-54) days were studied. They received 25 microg 100Mo/kg with a feed of human milk or formula. Fractional urinary and fecal collections were conducted preceding the 100Mo intake and for 48-72 hours afterwards. The materials were analyzed by atomic absorption spectroscopy and inductively coupled plasma mass spectrometry. The median absorption of 100Mo intake was 97.5 (96.3 to 99.1) %. The retention of nutritive Mo intake and 100Mo in the study period was 11.2 (3.8-15.7) microg Mo/kg, equivalent to 35.7 (12.7-55.6) %. The Mo concentration increased to a peak value in urine within 8 (6-13) hours and in feces within 24 (7-48.5) hours. In addition, increases of copper in feces and urine were observed in 8 of 9 infants studied. Mo given orally is well resorbed in premature infants, and predominantly excreted in the urine. Dietary recommendations should prevent excessive intakes in infancy.     

Effects of repeated creatine supplementation on muscle, plasma, and urine creatine levels

The purpose of this case study was to examine the effects of repeated creatine administration on muscle phosphocreatine, plasma creatine, and urine creatine. One male subject (age, 32 years; body mass, 78.4 kg; height, 160 cm; resistance training experience, 15 years) ingested creatine (20 g.d(-1) for 5 days) during 2 bouts separated by a 30-day washout period. Muscle phosphocreatine was measured before and after supplementation. On day 1 of supplementation, blood samples were taken immediately before and hourly for 5 hours following ingestion of 5 g of creatine, and a pharmacokinetic analysis of plasma creatine was conducted. Twenty-four-hour urine collections were conducted before and for 5 days during supplementation. Muscle phosphocreatine increased 45% following the first supplementation bout, decreased 22% during the 30-day washout period, and increased 25% following the second bout. There were no meaningful differences in plasma creatine pharmacokinetic parameters between bouts 1 and 2. Total urine creatine losses during supplementation were 63.2 and 63.4 g during bouts 1 and 2, respectively. The major findings were that (a) a 30-day washout period is insufficient time for muscle phosphocreatine to return to baseline following creatine supplementation but is sufficient time for plasma and urine creatine levels to return to presupplementation values; (b) postsupplementation muscle phosphocreatine levels were similar following bouts 1 and 2 despite 23% higher presupplementation muscle phosphocreatine before bout 2; and (c) the increased muscle phosphocreatine that persisted throughout the 30-day washout period corresponded with maintenance of increased body mass (+2.0 kg). Athletes should be aware that the washout period for muscle creatine to return to baseline levels may be longer than 30 days in some individuals, and this may be accompanied by a persistent increase in body mass.     

Variability in rates of urine prostaglandin E excretion

Urine prostaglandin E excretion rates were determined by hepatic receptor assay in three groups of conscious animals. Although 24-hour urine collections gave reproducibly similar levels of prostaglandin E excretion rates, levels obtained with consecutive 20-minute urine collections were extremely variable despite no obvious changes in renal function. Since short urine collection periods are used frequently in physiologic studies, the significance of variations in prostaglandin excretion rates in these studies may have to be re-evaluated.     

Variability in rates of urine prostaglandin E excretion

Urine prostaglandin E excretion rates were determined by hepatic receptor assay in three groups of conscious animals. Although 24-hour urine collections gave reproducibly similar levels of prostaglandin E excretion rates, levels obtained with consecutive 20-minute urine collections were extremely variable despite no obvious changes in renal function. Since short urine collection periods are used frequently in physiologic studies, the significance of variations in prostaglandin excretion rates in these studies may have to be re-evaluated.     

Is the Xylose Test still a Worth-while Investigation?

In a retrospective survey the results of a D-xylose absorption test have been assessed in relation to jejunal morphology and final diagnosis in 152 adult patients with various types of gastrointestinal disease. Neither urine excretion rates nor serum concentrations alone provide an adequate separation between patients with definite mucosal lesions and those without evidence of gut disease or with other types of gastrointestinal pathology.It is suggested that when a jejunal biopsy can readily be performed the xylose test serves little useful purpose in routine practice and can be positively misleading. It may still be useful as a screening test for referral for jejunal biopsy, provided that strict criteria of normality are applied.     

Results of oral methionine loads in normal subjects and patients with liver diseases using an analyzer short program

Control subjects and patients with liver diseases (cirrhosis, fatty liver) were given an oral methionine load with 100 mg L-Met/kg body weight. Amino acid chromatography was made by a short-program particularly suitable for the diagnosis of hereditary disorders of methionine metabolism. Met-tolerance in blood plasma as well as cystathionine, homocystine and the mixed disulfide homocysteine-cysteine in plasma and urine were investigated. Methylmalonic acid excretion in the urine was determined by gas chromatography. Patients with liver diseases showed some pathological changes of methionine tolerance after the load. However, cystathionine and homocysteine could not be demonstrated. No methylmalonic acid excretion occurred in normal subjects and patients with liver diseases after the methionine load.     

Relationship between 24-hour urinary-free cortisol excretion and salivary cortisol levels sampled from awakening to bedtime in healthy subjects

The utility of repeated salivary cortisol sampling as a substitute for 24-hour urinary-free cortisol (UFC) assessment was examined. Forty-four participants completed both 24-hour collections and 6 salivary collections at wake-up, 08:00, 12:00, 16:00, 20:00 and bedtime, during the same 24-hour period. The results demonstrated that mean, maximum, and amplitude (maximum minus minimum) for salivary cortisol all correlated positively with urinary cortisol, but the associations of these variables with urinary-free cortisol excretion were relatively small. Furthermore, a single salivary sample taken at wake-up was as good an indicator of overall cortisol production as the measures derived from multiple salivary samples. An examination of subject compliance indicated that many subjects failed to collect the timed salivary collections as instructed. The authors conclude that diurnal salivary cortisol sampling versus 24-hour urinary cortisol collections are likely to provide different information about ambient hypothalamic-pituitary-adrenal productivity, and therefore these measures should not be used interchangeably. In addition, subject compliance is a serious consideration in designing studies that employ home salivary collections.     

Reduction in human urinary MHPG excretion by guanethidine: urinary MHPG as index of sympathetic nervous activity.

The norepinephrine metabolites methoxyhydroxyphenyl glycol (MHPG) and vanillylmandelic acid (VMA) were measured in the urine of hypertensive subjects before and during adminstration of guanethidine, a peripheral sympatholytic agent which does not cross the blood-brain barrier or deplete adrenal catecholamines. Dosages of guanethidine (1.2 mg/kg/day) sufficient to cause at least a 20 torr reduction in standing systolic blood pressure caused a mean 63% (maximum of 68%) reduction in urinary MHPG excretion (p=0.01) while only causing a mean 37% (maximum of 44%) reduction (p<0.005) in excretion of VMA. These results indicate that MHPG in human urine, as in lower animals, is predominantly the product of peripheral sympathetic nervous system, rather than central nervous system nonrepinephrine metabolism. Urinary MHPG is more sensitive to specific sympatholytic therapy than is urinary VMA, and may be a useful index of sympathetic nervous activity.     

Potassium changes in trained subjects after potassium loading and during restriction of muscular activity and chronic hyperhydration

The objective of this investigation was to determine whether urinary and plasma potassium changes developed during prolonged hypokinesia (HK) (decreased number of km/d) in endurance-trained subjects could be minimized or reversed with a daily intake of fluid and salt supplementation (FSS). The studies were performed on 30 endurance-trained male volunteers aged 23–26 yr with an average peak oxygen uptake of 65 mL/kg min during 364 d of HK. All volunteers were on an average of 13.8 km/d prior to their exposure to HK. All volunteers were randomly divided into three groups: 10 volunteers were placed continuously under an average of 14.0 km/d (control subjects), 10 volunteers were subjected continuously to an average of 2.7 km/d (unsupplemented hypokinetic subjects), and 10 volunteers were submitted continuously to an average of 2.7 km/d, and consumed daily an additional amount of 0.1 g sodium chloride (NaCl)/kg body wt and 30 mL water/kg body wt (supplemented hypokinetic subjects). During the prehypokinetic period of 60 d and during the hypokinetic period of 364 d, potassium loading tests were performed with 1.5–1.7 mEq potassium chloride/kg body wt, and potassium, sodium, and chloride excretion in urine and potassium, sodium, and chloride in plasma were determined. In the unsupplemented hypokinetic volunteers, urinary excretion of electrolytes and concentrations of electrolytes in plasma increased significantly as compared to the control and supplemented hypokinetic groups of volunteers. It was concluded that daily intake of fluid and salt supplementation had a favorable effect on regulation of urinary and plasma potassium changes in trained subjects during prolonged HK.     

The protective role of metallothionein in copper-overload: II. Transport and excretion of immunoreactive MT-1 in blood, bile and urine of copper-loaded rats

The regulation of copper homeostasis in copper overloaded animals occurs by excretion of excess of the metal in bile and urine, which may be facilitated by metallothionein (MT) a copper binding protein. The role of MT in the mobilisation and excretion of copper excess has been studied in copper-loaded rats during the development of tolerance. Young male Wistar rats were fed a high copper (1 g/kg) diet for 16 weeks during which period they were killed after prior collection of bile, blood and urine for analysis for copper and immunoreactive MT-1. In addition bile was separated chromatographically and the eluant fractions were assessed likewise for copper and MT-1. Biliary excretion of copper and MT-1 rose to a maximum after 6 weeks, falling subsequently as the rats became copper tolerant. Early increases in circulating copper and MT-1 occurred likewise but whereas MT-1 fell subsequently during the recovery period, serum copper remained elevated. By contrast, urinary copper and MT-1 maintained an increased output throughout. Chromatographic separation of bile revealed the presence of a range of immunoreactive MT-1 degradation products. It was concluded that the close correspondence between bile and serum MT reflected their hepatic derivation and implicated liver MT as an export protein in the early stages of copper overload. By contrast, urine MT, maintained independently of circulating MT levels, established the active secretory participation of the kidney in promoting the continued depletion of excess copper.     

172名上海地区成人饮食及尿雌马酚和代谢产物的调查研究

目的确定上海地区成人雌马酚代谢表型及雌马酚的生理范围;把握由于大豆异黄酮负荷而产生的雌马酚产生者比例;调查雌马酚表型和食物摄取频率及有关激素间的关系。方法应用现状调查方法,筛选出172名居住在上海市区健康成年男女。填写问卷获得研究对象日常饮食频率,检测研究对象血清获得血液激素浓度,采用HPLC法分析负荷大豆异黄酮前后尿中雌马酚等大豆异黄酮24 h排泄量,统计产雌马酚者比例及其与摄食频率和激素的关系。结果负荷前雌马酚生理范围0~33.74μmol/24 h,产雌马酚者比例为30.2%,负荷大豆异黄酮后比例提高至53.5%。产雌马酚者与非产雌马酚者之间日常食品摄取频率的差别无统计学意义(P>0.05)。产Eq者血中游离雌二醇的浓度较非产Eq者低(P<0.05)。结论在通常膳食条件下,约有1/3上海成人尿液中能检测到雌马酚,但负荷大豆异黄酮后,约有1/2能产生雌马酚。