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Li Y, Kong Y, Hu Y, Li Y, Asrosa R, Zhang W, Deka Boruah B, Yetisen AK, Davenport A, Lee TC, Li B. A paper-based dual functional biosensor for safe and user-friendly point-of-care urine analysis. LAB ON A CHIP 2024; 24:2454-2467. [PMID: 38644805 PMCID: PMC11060138 DOI: 10.1039/d4lc00163j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
Safe, accurate, and reliable analysis of urinary biomarkers is clinically important for early detection and monitoring of the progression of chronic kidney disease (CKD), as it has become one of the world's most prevalent non-communicable diseases. However, current technologies for measuring urinary biomarkers are either time-consuming and limited to well-equipped hospitals or lack the necessary sensitivity for quantitative analysis and post a health risk to frontline practitioners. Here we report a robust paper-based dual functional biosensor, which is integrated with the clinical urine sampling vial, for the simultaneous and quantitative analysis of pH and glucose in urine. The pH sensor was fabricated by electrochemically depositing IrOx onto a paper substrate using optimised parameters, which enabled an ultrahigh sensitivity of 71.58 mV pH-1. Glucose oxidase (GOx) was used in combination with an electrochemically deposited Prussian blue layer for the detection of glucose, and its performance was enhanced by gold nanoparticles (AuNPs), chitosan, and graphite composites, achieving a sensitivity of 1.5 μA mM-1. This dual function biosensor was validated using clinical urine samples, where a correlation coefficient of 0.96 for pH and 0.98 for glucose detection was achieved with commercial methods as references. More importantly, the urine sampling vial was kept sealed throughout the sample-to-result process, which minimised the health risk to frontline practitioners and simplified the diagnostic procedures. This diagnostic platform, therefore, holds high promise as a rapid, accurate, safe, and user-friendly point-of-care (POC) technology for the analysis of urinary biomarkers in frontline clinical settings.
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Affiliation(s)
- Yujia Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Yingqi Kong
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Yubing Hu
- Department of Chemical Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Yixuan Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Rica Asrosa
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
- Department of Physics, Faculty of Mathematics and Natural Science, Universitas Sumatera Utara, Medan 20155, Sumatera Utara, Indonesia
| | - Wenyu Zhang
- Department of Materials, University of Oxford, Parks Road, Oxford, OX1 3PH, UK
| | - Buddha Deka Boruah
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
| | - Ali K Yetisen
- Department of Chemical Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Andrew Davenport
- UCL Department of Renal Medicine, Royal Free Hospital, University College London, Rowland Hill Street, London, NW3 2PF, UK
| | - Tung-Chun Lee
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
| | - Bing Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
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Angerri O, Gracia S, Rousaud F, Kanashiro A, Emiliani E. Entering into 2.0 cystinuric management with a medical digital tool to monitor urine pH: a prospective, randomized study. Actas Urol Esp 2023; 47:560-565. [PMID: 37086842 DOI: 10.1016/j.acuroe.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Individuals with cystinuria can experiment recurrent lithiasis events due to the relative insolubility of cystine at physiological urine pH, resulting in renal function decline. The Lit-Control® pH Meter is a medical device that accurately allows urine pH self-monitoring. The main objective of this study was to compare the usability of the Lit-Control® pH Meter with the reactive strips for self-monitoring of urinary pH at home by patients with cystinuria, and their overall satisfaction with each tool. PATIENTS AND METHODS We included 28 patients (9 females and 19 males, age 19-76 years), who were randomly assigned to monitor their urine pH with reactive strips (n = 17) or the Lit-Control® pH-meter (n = 11). RESULTS After six months of use, the satisfaction with the two methods was similarly high, but the patients rated (0-10 scale) the pH meter better in terms of ease of learning (mean ± SD, 8.11 ± 0.60 vs. 7.06 ± 1.18; P = 0.038), ease to prepare (8.22 ± 0.67 vs. 7.25 ± 1.18; P = 0.034), and ease of use (8.22 ± 0.67 vs. 7.25 ± 1.39; P = 0.062). Overall, patients did not reach the alkalinization goals (pH between 7.0 and 8.0). CONCLUSIONS The Lit-Control® pH Meter demonstrated to be an easy-to-use device that can facilitate urinary pH control by cystinuric patients. A prospective study is warranted to assess the correlation between urine pH monitoring, a treat to target approach, and the recurrence of cystine stones.
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Affiliation(s)
- O Angerri
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - S Gracia
- Department of Laboratory and Biochemistry, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - F Rousaud
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Kanashiro
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Emiliani
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
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Kamphuis GM, van Hattum JW, van Dongen-Lases EC, Henderickx MMEL, Beerlage HP. Introduction of a Standardized Approach of Electronic Urinary pH Monitoring to Assist Alkalization Therapy: A Uric Acid Urolithiasis Patient's Perspective. J Endourol 2021; 35:1563-1570. [PMID: 34210175 DOI: 10.1089/end.2020.0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: This study evaluates the introduction of an electronic pH meter to measure the urinary pH in patients with uric acid (UA) urolithiasis and assess patient's perspective. Materials and Methods: Patients known with UA urolithiasis were included in this single-center, nonrandomized, prospective feasibility study, IDEAL stage 2a. Their experience with urolithiasis and satisfaction with the method of urinary pH monitoring before inclusion was evaluated. All patients received an electronic pH meter and standardized instructions. After a period of 6-12 weeks their experience and satisfaction with this pH meter and new regimen was assessed. Patient satisfaction was scored on a Likert scale 1-5. Results: Eighteen patients were included. Median age was 63 years and median body mass index was 30 kg/m2. The cohort consisted of 67% men and 33% women. In their medical history, 55% had unilateral stones, whereas 45% had bilateral stones. The median estimated glomerular filtration rate was 58 mL/minute/1.73 m2. Eighty-nine percent took medication to alkalize their urine, median 3.5 years. Fifteen patients used paper reagent strips and three used an electronic pH meter to assess urinary pH before this study. Satisfaction with the method of urinary pH measurement at inclusion was reasonable (median score 3; interquartile range [IQR] 1-4). Satisfaction with the new electronic pH meter was good (median score 4; IQR 3-5), as was the overall satisfaction (median score 4; IQR 3-5). The new electronic pH meter was slightly easier to use (median 3.5; IQR 1.75-5), as easy in maintenance (median 3; IQR 2-4), and significantly easier to read (median 5; IQR 4-5). The new electronic pH meter was better (median score 4; IQR 2.75-5) than their previous method. Conclusion: The introduction of a standardized approach of urinary pH monitoring for UA urolithiasis patients with an electronic pH meter leads to an easier interpretable outcome and higher patient satisfaction.
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Affiliation(s)
- Guido M Kamphuis
- Department of Urology and Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jons W van Hattum
- Department of Urology and Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Edmée C van Dongen-Lases
- Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Harrie P Beerlage
- Department of Urology and Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Parasthi LYE, Afifah DN, Nissa C, Panunggal B. Total Lactic Acid Bacteria and Antibacterial Activity in Yoghurt with Addition of Ananas comosus Merr. and Cinnamomum burmannii. AMERTA NUTRITION 2020. [DOI: 10.20473/amnt.v4i4.2020.257-264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Diarrhea disease is one of gastrointestinal disorders which is the second leading cause of death in children under five years. Food and beverage contamination is the biggest cause of diarrhea in developing countries. Nanas madu (Ananas comosus Merr.) and cinnamon (Cinnamomum burmannii) have antibacterial properties that can inhibit the growth of Escherichia coli and Salmonella typhi causing diarrhea.Objective: This study aimed to analyze the total differences of Lactic Acid Bacteria (LAB) and antibacterial activity in yoghurt with the addition of nanas madu and cinnamon extract.Methods: This was an experimental study with various treatment in adding honey cream pineapple (0%, 20%, 40%, and 60%) and cinnamon extract (4% and 6%). Total LAB was calculated using the Total Plate Count (TPC) method and antibacterial activity was tested using Kirby Bauer method.Results: There was no significant difference in yoghurt with the addition of honey cream pineapple and cinnamon extract. Yoghurt with the highest LAB was yoghurt with addition 40% of honey cream pineapple and 6% of cinnamon extract (N40M2) with total LAB 1,43 x 1019 CFU/ml. The results of the antibacterial activity showed no significant difference of inhibition zone against S. typhi¸ while there was significant difference of inhibition zone against E. coli. The highest activity against S. typhi was yoghurt with addition 60% of honey cream pineapple and 4% of cinnamon extract (N60M1) resulting 6,81 mm inhibition zone and the highest activity against E. coli was N40M1 resulting 6,77 mm of inhibition zone. Conclusion: Total LAB yoghurt with the addition of nanas madu and cinnamon extract have met FAO and SNI standards with LAB minimum 107 CFU/ml. Antibacterial activity of all yoghurt treatment categorized as medium inhibition (5-10 mm).
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Urine and stone analysis for the investigation of the renal stone former: a consensus conference. Urolithiasis 2020; 49:1-16. [PMID: 33048172 PMCID: PMC7867533 DOI: 10.1007/s00240-020-01217-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/11/2020] [Indexed: 01/08/2023]
Abstract
The Consensus Group deliberated on a number of questions concerning urine and stone analysis over a period of months, and then met to develop consensus. The Group concluded that analyses of urine and stones should be routine in the diagnosis and treatment of urinary stone diseases. At present, the 24-h urine is the most useful type of urine collection, and accepted methods for analysis are described. Patient education is also important for obtaining a proper urine sample. Graphical methods for reporting urine analysis results can be helpful both for the physician and for educating the patient as to proper dietary changes that could be beneficial. Proper analysis of stones is also essential for diagnosis and management of patients. The Consensus Group also agreed that research has shown that evaluation of urinary crystals could be very valuable, but the Group also recognizes that existing methods for assessment of crystalluria do not allow this to be part of stone treatment in many places.
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Urinalysis Using a Diaper-Based Testing Device. BIOSENSORS-BASEL 2020; 10:bios10080094. [PMID: 32785051 PMCID: PMC7459906 DOI: 10.3390/bios10080094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 01/24/2023]
Abstract
Urinary tract infections (UTI), one of the most common bacterial infections, annually affect 150 million people worldwide. Infants and the elderly are likely to have missed or delayed diagnosis of UTI due to difficulty clearly describing their symptoms. A rapid screening method for UTI is a critical and urgent need for these populations. The aim of our study is to develop a diaper-based testing device to assay urine biomarkers including pH, leukocyte, and nitrite level. This all-in-one device assists in urine collection and testing using a colorimetric approach to provide easily read visual results on the outside surface of a test strip-integrated diaper. In this study, we tested samples from 46 patients using testing strips and examined the results from 7 patients recruited to validate the strip-integrated diaper. In conclusion, this new diaper-based testing device is easy to use, rapid, and inexpensive, all of which imbue it with tremendous potential for development into a commercially viable UTI screening system.
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Torrecilla C, Fernández-Concha J, Cansino JR, Mainez JA, Amón JH, Costas S, Angerri O, Emiliani E, Arrabal Martín MA, Arrabal Polo MA, García A, Reina MC, Sánchez JF, Budía A, Pérez-Fentes D, Grases F, Costa-Bauzá A, Cuñé J. Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: a multicenter, placebo controlled, double blind, randomized clinical trial. BMC Urol 2020; 20:65. [PMID: 32503502 PMCID: PMC7275439 DOI: 10.1186/s12894-020-00633-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/21/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Encrustation of ureteral double J stents is a common complication that may affect its removal. The aim of the proposed study is to evaluate the efficacy and safety of a new oral composition to prevent double J stent encrustation in indwelling times up to 8 weeks. METHODS A double-blinded, multicenter, placebo-controlled trial was conducted with 105 patients with indwelling double J stents enrolled across 9 public hospitals in Spain. The patients were randomly assigned (1:1) into intervention (53 patients) or placebo (52 patients) groups for 3 to 8 weeks and both groups self-monitored daily their morning urine pH levels. The primary outcome of analysis was the degree of stent ends encrustation, defined by a 4-point score (0 - none; 3 - global encrustation) using macroscopic and electron microscopy analysis of crystals, after 3 to 8-w indwelling period. Score was exponentially transformed according to calcium levels. Secondary endpoints included urine pH decrease, stent removal, and incidence of adverse events. RESULTS The intervention group benefits from a lower global encrustation rate of stent ends than placebo group (1% vs 8.2%; p < 0.018). Mean encrustation score was 85.12 (274.5) in the placebo group and 18.91 (102.27) in the intervention group (p < 0.025). Considering the secondary end points, treated patients reported greater urine pH decreases (p = 0.002). No differences in the incidence of adverse events were identified between the groups. CONCLUSIONS Our data suggest that the use of this new oral composition is beneficial in the context of ureteral double J indwelling by decreasing mean, as well as global encrustation. TRIAL REGISTRATION This trial was registered at www.clinicaltrials.gov under the name "Combined Use of a Medical Device and a Dietary Complement in Patient Urinary pH Control in Patients With an Implanted Double J Stent" with date 2nd November 2017, code NCT03343275, and URL.
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Affiliation(s)
| | | | | | | | - José H Amón
- Rio Hortega University Hospital, Valladolid, Spain
| | | | | | | | | | | | - Ana García
- Virgen de Valme University Hospital, Sevilla, Spain
| | | | | | - Alberto Budía
- University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Daniel Pérez-Fentes
- University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Félix Grases
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS- IDISBA), University of Balearic Islands (UIB), Palma de Mallorca, Spain.
| | - Antonia Costa-Bauzá
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS- IDISBA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Jordi Cuñé
- Devicare S.L., Cerdanyola del Vallès, Spain
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Kamphuis GM, Wouter van Hattum J, de Bie P, Somani BK. Method of alkalization and monitoring of urinary pH for prevention of recurrent uric acid urolithiasis: a systematic review. Transl Androl Urol 2019; 8:S448-S456. [PMID: 31656751 DOI: 10.21037/tau.2019.05.01] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Uric acid (UA) urolithiasis comprises around 5-10% of all stones and can frequently recur. Due to the fact that UA stones form in acidic urine with a pH <5.5, these patients require special attention compared to other stone patients. The international guidelines suggest treatment and metaphylaxis by urinary alkalization. The objective of this review is to critically asses the available evidence concerning the method and efficacy of this treatment modality. A systematic review on the methods of metaphylactic therapy using oral alkalization of UA urolithiasis was conducted by two authors. Evidence was sought using a predefined search strategy in seven different databases. The provided evidence was critically evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane collaboration tool for assessing the risk of bias. Twelve manuscripts were included of which one was a randomised trial. They focussed on ways to alkalize urine and its effect on stone recurrence. Because of their methodology and heterogeneity, the evidence is presented in a narrative review. There were differences in medication used for alkalizing urine, ways of monitoring urine pH and evaluating its efficacy. The reported outcomes also differed between studies. There is currently a lack of clear evidence for the method of alkalization of urine and the method of pH measurement. Besides this, for an established treatment modality, there is lack of long term results for the alkalization therapy. In conclusion, urine alkalization is an established treatment modality for the metaphylaxis of UA urolithiasis despite the lack of evidence from high quality studies on the methods of alkalization and its treatment efficacy. The studies published on this topic are scarce and contain notable risks of bias which should be kept in mind when interpreting the stated results.
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Affiliation(s)
- Guido Maarten Kamphuis
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jons Wouter van Hattum
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Prim de Bie
- Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
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