scholarly journals Assessment of the degree of adherence of medical laboratories to KDIGO 2012 guideline for evaluation and management of CKD in Czechia and Slovakia

2019 ◽  
Vol 29 (3) ◽  
pp. 522-530 ◽  
Author(s):  
Šálek Tomáš ◽  
Friedecký Bedřich ◽  
Kratochvíla Josef ◽  
Pelinková Květa ◽  
Budina Marek
Keyword(s):  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
External Quality Assessment ◽  
Metrological Traceability ◽  
Further Education ◽  
Urinary Albumin ◽  
Albumin Concentration ◽  
Medical Laboratories ◽  
Creatinine Measurement ◽  
Urinary Albumin Concentration

Introduction: The aim of the study is to assess the degree of adherence of medical laboratories to Kidney Disease Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD) in laboratory practice in Czechia and Slovakia. Materials and methods: An electronic questionnaire on adherence to KDIGO 2012 guideline was designed by an external quality assessment (EQA) provider SEKK spol. s.r.o. The questionnaire was placed and distributed through website to all medical biochemistry laboratories in Czechia and Slovakia (N = 396). Results: A total of 212 out of 396 laboratories responded to the questions, though some laboratories only answered some questions, those applicable to their practice. A total of 48 out of 212 laboratories adopted the KDIGO 2012 guideline in full extent. The metrological traceability of creatinine measurement to standard reference material of SRM 967 was declared by 180 out of 210 laboratories (two of the responding laboratories did not measure creatinine). Thirty laboratories are not well educated on traceability of creatinine measurement and seven laboratories do not calculate estimated glomerular filtration rate (eGFR). Both urinary albumin concentration and albumin to creatinine ratio are reported by 144 out of 175 laboratories (37 of the responding laboratories did not measure urinary albumin). Conclusion: Majority of laboratories in Czechia and Slovakia adopted some parts of the KDIGO 2012 guideline in their practice, but only 23% of the laboratories apply them completely. Thus, further education and action should be conducted to improve its implementation.

scholarly journals Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project

2021 ◽  
Author(s):  
Elisa Russo ◽  
◽  
Francesca Viazzi ◽  
Roberto Pontremoli ◽  
Carlo Maria Barbagallo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Urinary Albumin ◽  
Albumin Concentration ◽  
Heart Health ◽  
The Relationship ◽  
Urinary Albumin Concentration ◽  
Shed Light

Abstract Background Hyperuricemia is commonly observed in patients with chronic kidney disease (CKD). However, a better understanding of the relationship among uric acid (UA) values, glomerular filtration rate (GFR) and albuminuria may shed light on the mechanisms underlying the excess of cardiovascular mortality associated with both chronic kidney disease and hyperuricemia and lead to better risk stratification. Our main goal was to study the relationships between serum uric acid and kidney disease measures (namely estimated GFR [eGFR] and albuminuria) in a large cohort of individuals at cardiovascular risk from the URic acid Right for heArt Health (URRAH) Project database. Methods Clinical data of 26,971 individuals were analyzed. Factors associated with the presence of hyperuricemia defined on the basis of previously determined URRAH cutoffs for cardiovascular and all-cause mortality were evaluated through multivariate analysis. Chronic kidney disease was defined as eGFR < 60 ml/min per 1.73 m2 and/or abnormal urinary albumin excretion diagnosed as: (i) microalbuminuria if urinary albumin concentration was > 30 and ≤ 300 mg/L, or if urinary albumin-to-creatinine ratio (ACR) was > 3.4 mg/mmol and ≤ 34 mg/mmol; (ii) macroalbuminuria if urinary albumin concentration was > 300 mg/L, or if ACR was > 34 mg/mmol. Results Mean age was 58 ± 15 years (51% males, 62% with hypertension and 12% with diabetes), mean eGFR was 81 ml/min per 1.73m22with a prevalence of eGFR < 60 and micro- or macroalbuminuria of 16, 15 and 4%, respectively. Serum uric acid showed a trend towards higher values along with decreasing renal function. Both the prevalence of gout and the frequency of allopurinol use increased significantly with the reduction of eGFR and the increase in albuminuria. Hyperuricemia was independently related to male gender, eGFR strata, and signs of insulin resistance such as body mass index (BMI) and triglycerides. Conclusions The lower the eGFR the higher the prevalence of hyperuricemia and gout. In subjects with eGFR < 60 ml/min the occurrence of hyperuricemia is about 10 times higher than in those with eGFR > 90 ml/min. The percentage of individuals treated with allopurinol was below 2% when GFR was above 60 ml/min, it increased to 20% in the presence of CKD 3b and rose further to 35% in individuals with macroalbuminuria. Graphic abstract

scholarly journals Characterization of Immunochemically Nonreactive Urinary Albumin

2004 ◽  
Vol 50 (12) ◽  
pp. 2286-2291 ◽  
Author(s):  
Tanya M Osicka ◽  
Wayne D Comper
Keyword(s):  
Disulfide Bonds ◽  
Polyacrylamide Gel Electrophoresis ◽  
Sodium Dodecyl ◽  
Clinical Importance ◽  
Urinary Albumin ◽  
Albumin Concentration ◽  
Urinary Proteins ◽  
Native Page ◽  
Sds Page ◽  
Urinary Albumin Concentration

Abstract Background: Conventional immunoassays underestimate the urinary albumin concentration because intact albumin in urine exists in two forms, immunoreactive and immunochemically nonreactive. Methods: Urinary albumin concentration measured by HPLC (which measures total albumin, i.e., the sum of immunoreactive albumin + immunochemically nonreactive albumin) or RIA was compared with densitometric analysis of albumin bands in diabetic urine samples separated by either native polyacrylamide gel electrophoresis (PAGE) or reducing sodium dodecyl sulfate (SDS)-PAGE. Immunochemically nonreactive albumin was also isolated from diabetic urine (relative amount detected, 70–80% of the expected) and was tested for contamination by common urinary proteins by native PAGE, ELISA, and capillary electrophoresis. Results: Urinary albumin concentrations measured by native PAGE and HPLC were better correlated (r2 = 0.83) than concentrations measured by native PAGE and RIA (r2 = 0.62) because under native conditions both native PAGE and HPLC detect total albumin and not only the immunoreactive albumin alone that is measured by RIA. Urinary albumin concentrations measured by reducing SDS-PAGE and RIA were better correlated (r2 = 0.84) than concentrations measured by reducing SDS-PAGE and HPLC (r2 = 0.65) because under reducing conditions immunochemically nonreactive albumin is unstable and fragments into many smaller peptides. The partially purified preparation was found to contain &lt;1% contamination by common urinary proteins and is stable to freezing and frequent freeze/thaw cycles. Conclusions: The results are consistent with the interpretation that immunochemically nonreactive albumin has a limited number of polypeptide chain scissions and is held together by noncovalent intrachain bonding and disulfide bonds. Detection of this molecule is likely to be of clinical importance in diagnosing kidney disease as well as cardiovascular disease.

Is a random urinary albumin concentration a useful screening test in insulin-treated diabetic patients?

1994 ◽  
Vol 163 (9) ◽  
pp. 406-409 ◽  
Author(s):  
O. L. Beatty ◽  
C. M. Ritchie ◽  
D. R. Hadden ◽  
L. Kennedy ◽  
P. M. Bell ◽  
...  
Keyword(s):  
Screening Test ◽  
Urinary Albumin ◽  
Diabetic Patients ◽  
Albumin Concentration ◽  
Urinary Albumin Concentration

scholarly journals Plasma creatine concentration is associated with incident hypertension in a cohort enriched for the presence of high urinary albumin concentration

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Adrian Post ◽  
Daan Kremer ◽  
J. Casper Swarte ◽  
Sara Sokooti ◽  
Fabian A. Vogelpohl ◽  
...  
Keyword(s):  
Urinary Albumin ◽  
Albumin Concentration ◽  
Incident Hypertension ◽  
Urinary Albumin Concentration

External Quality Assessment in the Examination of Blood Films for Malarial Parasites Within Ontario, Canada

2000 ◽  
Vol 124 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Sam Thomson ◽  
Reinhard C. Lohmann ◽  
Linda Crawford ◽  
Ruby Dubash ◽  
Harold Richardson
Keyword(s):  
Quality Assessment ◽  
External Quality Assessment ◽  
Good Practice ◽  
Further Education ◽  
Educational Strategies ◽  
External Quality ◽  
Medical Laboratories ◽  
Detection And Identification ◽  
Total Testing Process

Abstract Objective.—To assess laboratory practice in the examination of blood films for malarial parasites. Method.—Ontario medical laboratories, licensed by the Ministry of Health, are required to participate in external quality assessment by the Laboratory Proficiency Testing Program, which assesses performance of laboratory assays and also examines the total testing process. Educational strategies are used to improve performance. Results.—A 1995 survey indicated shortcomings in detection and identification of malarial parasites in blood films. Consequently, recommendations for the investigation of malarial parasites in blood were issued. In 1996 and 1997, 16 workshops were conducted. A 1997 follow-up external quality assessment survey indicated that problems persist as 27% of laboratories failed to correctly speciate Plasmodium falciparum. Good Practice Guidelines were issued in 1998. Conclusion.—Further education and assessment are required. Laboratories lacking expertise must establish referral arrangements with more proficient laboratories.

Sign in / Sign up

Export Citation Format

Share Document