Preanalytical handling of stored urine samples, and measurement of beta 2-microglobulin, orosomucoid, albumin, transferrin and immunoglobulin G in urine by enzyme-linked immunosorbent assays (ELISA)

Associations of urinary orosomucoid, N-acetyl-β-D-glucosaminidase, and albumin with blood pressure and hypertension after 7 years. The Tromsø Study

Purpose: Subclinical chronic kidney disease is known to exacerbate hypertension and progression of kidney damage. In order to initiate timely interventions, early biomarkers for this vicious circle are needed. Our aim was to describe the cross-sectional associations of urinary orosomucoid and urinary N-acetyl-β-D-glucosaminidase (NAG) with blood pressure and the longitudinal associations of urinary orosomucoid and NAG to hypertension after 7 years, and to compare the strength of these associations to the urinary albumin excretion (UAE).Material and methods: The Tromsø Study is a population-based, prospective study of inhabitants of the municipality of Tromsø, Northern Norway. Morning spot urine samples were collected on three consecutive days in the Tromsø 6 survey (2007-2008). We assessed the cross-sectional associations of urinary orosomucoid, NAG and UAE with blood pressure in Tromsø 6. In a cohort of participants attending Tromsø 6 and Tromsø 7 (2015-2016), we studied whether urinary biomarkers were longitudinally associated with hypertension.Results: A total of 7197 participants with a mean age of 63.5 years (SD 9.2), and a mean blood pressure of 141/78 mmHg (SD 23.0/10.6), were included in the study. Orosomucoid and UAE, but not NAG, was significantly associated with systolic and diastolic blood pressure in all the crude and multivariable cross-sectional analyses. Orosomucoid had consistently, although marginally, stronger associations with blood pressure. Incident hypertension at follow-up (Tromsø 7) was consistently significantly associated with urinary orosomucoid, but not urinary NAG or UAE. However, the standardized regression coefficients for orosomucoid were only marginally stronger than the standardized regression coefficients for ACR.Conclusion: In a cohort from the general population urine orosomucoid had a stronger cross-sectional association with blood pressure than UAE. After 7 years, urine orosomucoid showed the strongest association with incident hypertension. There were varying and weak associations between U-NAG, blood pressure and hypertension.

Urinary orosomucoid is associated with diastolic dysfunction and carotid arteriopathy in the general population. Cross-sectional data from the Tromsø study

Objectives. Urinary albumin excretion is a risk marker for cardiovascular disease (CVD). Studies suggest that urinary orosomucoid may be a more sensitive marker of general endothelial dysfunction than albuminuria. The aim of this population-based cross-sectional study was to examine the associations between urinary orosomucoid to creatinine ratio (UOCR), urinary albumin to creatinine ratio (UACR) and subclinical CVD. Design. From the Tromsø Study (2007/2008), we included all men and women who had measurements of urinary orosomucoid (n = 7181). Among these, 6963 were examined with ultrasound of the right carotid artery and 2245 with echocardiography. We assessed the associations between urinary markers and subclinical CVD measured as intima media thickness of the carotid artery, presence and area of carotid plaque and diastolic dysfunction (DD). UOCR and UACR were dichotomized as upper quartile versus the three lowest. Results. High UOCR, adjusted for UACR, age, cardiovascular risk factors and kidney function, was associated with presence of DD in men (OR: 3.18, 95% CI [1.27, 7.95], p = .013), and presence of plaque (OR: 1.20, 95% CI [1.01, 1.44], p = .038) and intima media thickness in women (OR: 1.34, 95% CI [1.09, 1.65], p = .005). Analyses showed no significant interaction between sex and UOCR for any endpoints. UACR was not significantly associated with DD, but the associations with intima media thickness and plaque were of magnitudes comparable to those observed for UOCR. Conclusions. UOCR was positively associated with subclinical CVD. We need prospective studies to confirm whether UOCR is a clinically useful biomarker and to study possible sex differences.

A study on the effect of the internal exposure to (210)Po on the excretion of urinary proteins in rats

This study was designed to assess the feasibility of a noninvasive urine specimen for the detection of proteins as indicators of internal exposure to ionizing radiation. Three groups of rats (five in each group) were intravenously injected with 1601 ± 376, 10,846 ± 591 and 48,467 ± 2812 Bq of (210)Po in citrate form. A sham-exposed control group of five rats was intravenously injected with sterile physiological saline. Daily urine samples were collected over 4 days following injection. Purification and pre-concentration of urinary proteins were carried out by ultrafiltration using a 3000 Da molecular weight cutoff membrane filter. The concentration of common urinary proteins, namely albumin, alpha-1-acid glycoprotein, immunoglobulins IgA and IgG, was measured by an enzyme-linked immunosorbent assay. Urinary excretion of albumin decreased dose-dependently (p < 0.05) 96 h post-injection relative to the control group. In contrast, no statistically significant effects were observed for other proteins tested. The dose-dependent decrease in urinary excretion of albumin observed in this study underscores the need for further research, which may lead to the discovery of new biomarkers that would reflect the changes in the primary target organs for deposition of (210)Po.

Proteomic profiling of dog urine after European adder (Vipera berus berus) envenomation by two-dimensional difference gel electrophoresis

Between April and September every year, many dogs in Finland are bitten by Vipera berus berus, also known as the European adder, the only venomous snake in the area. Exposure to snake bite venom causes local and systemic symptoms and in severe cases can lead to death. Urine samples were collected from four dogs bitten by V. berus berus and treated in the intensive care unit of the Veterinary Teaching Hospital at the University of Helsinki. The inclusion criteria were a strong suspicion of an adder bite no more than two days before admission and clinical signs of an adder bite. Exclusion criteria were defined as ongoing treatment with glucocorticoids or a known history of liver or kidney diseases. Six privately owned, healthy dogs were obtained as controls. Samples were subjected to 2D-DIGE analysis. Image analysis was performed with DeCyder 7.0 2D software, and protein spots demonstrating a minimum 1.5-fold difference in average spot volume ratios between envenomed and control dogs with a Student's t-test p-value of less than 0.05 were picked and identified using LC-MS/MS. In 2D-DIGE analysis, seven proteins were significantly (p < 0.05) over-expressed in the urine of dogs bitten by V. berus berus compared to the control group. From these, five proteins were identified: beta-2-microglobulin (b2MG), alpha-1-antitrypsin (AAT), albumin, fetuin-B and superoxide dismutase (SOD1). Results indicate that envenomation by V. berus berus alter the urinary protein profile in dogs.

Challenges in urine bioanalytical assays: overcoming nonspecific binding

Dr Allena Ji is the Director of Bioanalytical Services, XenoBiotic Laboratories, Inc., NJ, USA. She has worked in the bioanalytical field for many years and accumulated rich experience in LC-MS/MS method development, method validation and sample analysis under GLP compliance in large pharmaceutical company and contract laboratory settings. In the past 10 years, Allena worked at Pfizer (Legacy of Wyeth) and investigated many small-molecule drug candidates for their nonspecific binding in urine assays. Nonspecific binding of compounds results in a severe underestimation of the compounds' concentrations and poor precision and accuracy in urine bioanalytical assays. To overcome nonspecific binding in urine assays, Allena and her colleagues developed a series of practical approaches for urine method development. By adding an appropriate anti-adsorptive agent at its optimum concentration to the urine collection containers, the nonspecific binding can be blocked. Urine assays have much higher hurdles than plasma assays due to nonspecific binding and variability of urine pH, salt concentration, volume and solubility of drug(s) in urine. A simple and systematic approach for urine method development is emphasized in this paper. Nonspecific binding is a very serious issue in bioanalytical urine assays where a compound(s) adsorbs to the container wall. The adsorption happens frequently in urine assays because urine lacks proteins and lipids that can bind to the analytes or solubilize lipophilic analytes. Therefore, urine bioanalytical assays tend to suffer from analyte losses more often than plasma assays. In the past decade, there have been many methods described to overcome nonspecific adsorption in urine assays based on individual analyte characteristics. However, a common and simple method development approach for various analytes has not been discussed and summarized. In this article we demonstrate, discuss and summarize a common approach to urine method development with a focus on overcoming adsorption issues. The advantages and limitations of commonly used anti-adsorptive agents, such as bovine serum albumin, zwitterionic detergents such as CHAPS, sodium dodecyl benzene sulfonate, β-cyclodextrin, Tween 80 and Tween 20 are discussed.

Urinary proteases degrade albumin: implications for measurement of albuminuria in stored samples

BACKGROUND

Previous studies have shown that albumin in stored urine samples degrades over time, and that albumin losses are greatest in samples with low pH conditions (pH < 5). Furthermore, the high-performance liquid chromatography (HPLC) assay for urinary albumin has been shown to be particularly susceptible to the effects of prolonged storage.

METHODS

Frozen urine samples, stored for 12 months at -70 and -20 degrees C, were analysed for albumin fragmentation. Urinary protease activity was investigated in vitro in urine adjusted to pH 2.3-2.5. Albumin was measured by nephelometry, HPLC and sodium dodecyl sulphate-polyacrylamide gel electrophoresis.

RESULTS

In the unadjusted samples, albumin was degraded in 11 out of 40 samples stored at -20 degrees C. In the in vitro experiments, both endogenous albumin and exogenous albumin added to urine were rapidly degraded into large fragments within minutes after adjustment to low pH. The fragments produced were consistent with those produced during digestion with pepsin and urinary degradation was completely inhibited by pepstatin. Albumin concentration measured by HPLC was most dramatically affected, with near-complete loss of albumin-sized material within one hour of incubation at pH 2.3-2.5. Sample reactivity with antiserum in a nephelometry assay initially declined then increased, possibly due to exposure of internal epitopes during albumin digestion.

CONCLUSIONS

This study demonstrated that proteases are present and active in stored human urine samples. Urinary albumin digestion occurred in a manner consistent with activity of endogenous urinary proteases. Adjustment to neutral pH or addition of protease inhibitors may be useful techniques for sample preservation.

A particle-enhanced turbidimetric immunoassay for quantitative determination of orosomucoid in urine: development, validation and reference values

Increased urinary orosomucoid excretion rate (UOER) is an independent predictor of cardiovascular and all-cause mortality in patients with type 2 diabetes, as demonstrated by a conventional, immunoturbidimetric method. We wanted to optimize the method by developing a fully automated, particle-enhanced turbidimetric (PET) immunoassay with a lower detection limit, to allow assessment of orosomucoid in urine in healthy individuals and patients. A micro-particle-based immunoreagent was prepared for a PET immunoassay. The calibration was traceable to the certified reference material (CRM 470) for specific human serum proteins. We studied 69 healthy adults (28 men and 41 women) to establish reference values for the new assay. The detection limit of orosomucoid in urine was found to be 0.05 mg/l, about 20 times lower than for the conventional assay. Within-run imprecision [CV%, (level)] was 6.7% (0.23 mg/l), 1.0% (1.08 mg/l) and 1.0% (4.69 mg/l). Total imprecision [CV%, (level)] was 10.4% (0.23 mg/l), 3.9% (1.08 mg/l) and 3.4% (4.69 mg/l). Reference values [median (2.5-97.5 percentiles)] for UOER were 0.36 (0.07-2.04) microg/min and for urinary orosomucoid/creatinine ratio 0.04 (0.009-0.17) mg/mmol. We describe a fully automated, transferable, sufficiently precise, high-sensitivity assay for orosomucoid in urine and present reference values traceable to CRM 470.

Orosomucoid in urine is a powerful predictor of cardiovascular mortality in normoalbuminuric patients with type 2 diabetes at five years of follow-up

AIMS/HYPOTHESIS

To study whether urinary orosomucoid excretion rate (UOER) predicts mortality in normoalbuminuric patients with diabetes at 5 years of follow-up, and to investigate the relationship between orosomucoid in serum and urine.

METHODS

A cohort of 578 patients with diabetes (430 type 2, 148 type 1) was followed prospectively for an average of 5 years. UOER was measured in timed overnight urine samples.

RESULTS

Eighty-two patients with type 2 diabetes and 17 patients with type 1 diabetes died. Among patients with type 2 diabetes, 251 (58%) had normoalbuminuria; increased UOER independently predicted cardiovascular mortality (OR 4.94, 95% CI 1.60-15.22; p<0.006) in those with normoalbuminuria and in the entire cohort of patients with type 2 diabetes (odds ratio 3.63, 95% CI 1.50-8.81; p<0.005). Patients with increased UOER had a higher all-cause mortality than those with normal UOER (log-rank test, p<0.001 for type 2 patients; p<0.04 for type 1 patients). In patients with type 1 diabetes, there were five cardiovascular deaths and no significant predictive value of UOER. Patients with increased UOER had a subclinical increase in serum orosomucoid.

CONCLUSION/INTERPRETATION

Increased UOER was an independent, powerful predictor of cardiovascular mortality in normoalbuminuric patients with type 2 diabetes and in the entire cohort of patients with type 2 diabetes. There were indications of UOER as being a valuable marker in type 1 diabetes that showed differences in survival between patients with normal versus increased UOER. Serum orosomucoid was associated with UOER; UOER may be a marker of low-grade inflammation in patients with diabetes.

Determination of canine beta2-microgloblin in plasma and urine by enzyme-linked immunosorbent assay

An enzyme-linked immunosorbent assay was developed for the determination of canine beta2-microglobulin (beta2-m) in plasma and urine. The detectable sensitivity for pure canine beta2-m was 0.05 microg/l and the analytical range was 0.1 to 50 microg/l. The mean analytical recovery when pure canine beta2-m was added to normal plasma was 101.9%. The mean analytical recovery in the urine was 102.1%. The intra-day variation coefficient was 3.1% in plasma, 4.3% in serum and 1.9% in urine. No difference was found between the concentration of beta2-m in plasma and serum (n=17). The concentration of beta2-m in the plasma of normal dogs was 1.82 +/- 0.57 mg/l (n=31). The mean excretion in 24 hr urine collected from normal dogs was 17.6 +/- 9.2 microg/l, 0.22 +/- 0.12 microg/kg of body weight or 14.2 +/- 9.4 microg/g of urine creatinine. The beta2-m creatinine index of random urine samples was 23.5 +/- 16.6 microg/g (n=26). There was a close correlation between the beta2-m creatinine index of 24 hr urine samples and that of random urine samples (r=0.872).

A novel configuration of bioartificial liver support system based on circulating microcarrier culture

The purpose of this investigation is to initiate a new bioartificial liver support system that utilizes circulating microcarrier cultures in the extracapillary space of a hollow fiber cartridge. The material exchange occurs on the membranes of the hollow fiber. Toxins are metabolized by the circulating cells on the microcarriers driven by a centrifugal pump. We inoculated 2-3 x 10E8 Hep G2 cells on 2.5 grams of Cytodex 3 microcarriers, and allowed them flowing in the extracapillary space of a modified plasma filter. 10% FCS Medium was pumped through the capillaries at different rates. Cells keep morphological integrity and functionality during the circulation. These preliminary results suggest that this configuration of a bioartificial liver support system offers a future investigation.

Detection by ELISA of low transferrin levels in bronchoalveolar secretions of preterm infants

Transferrin levels in bronchoalveolar secretions (BAS) are very low compared to serum levels in humans. For the exact measurement of transferrin concentrations in BAS a very sensitive assay was developed as a double sandwich enzyme immunoassay using the combination of a polyclonal and a monoclonal antibody against human transferrin. The measurable range of the assay was 1.5 to 100 ng/ml of human transferrin. The lowest measurable value was 0.84 ng/ml and the sensitivity of the assay was 0.88 ng/ml. The coefficient of variation was 14.1% for 25 ng/ml (intra-assay) and 11-20% (inter-assay). The levels measured in 123 samples of BAS of preterm infants ranged between 0.03 and 8.93 (microgram/microgram secretory component (SC)). The determination of transferrin in BAS of preterm infants is helpful in determining oxidative damage, e.g. the availability of free iron, in the neonatal lung. The transferrin concentration in BAS of neonates who recovered from respiratory distress syndrome (RDS) in the first six days of life was 0.48 compared to 0.52 ((microgram/microgram SC), median range) for infants who developed chronic lung disease.

Freezing method affects the concentration and variability of urine proteins and the interpretation of data on microalbuminuria. The Oxford Regional Prospective Study Group

AIMS

Microalbuminuria and, to a lesser extent, renal tubular proteins are widely used in the early detection of incipient nephropathy in diabetes mellitus. Recent reports have indicated detrimental effects of storage at -20 degrees C on urine proteins. This study investigated the effects of storage on the measurement of urine proteins and discusses implications for the interpretation of data.

METHODS

Two-hundred and sixty-eight specimens, collected from children with Type 1 diabetes, split into duplicate aliquots and stored at -20 degrees C and -70 degrees C, respectively, for 6-8 months, were analysed for albumin, retinol binding protein, N-acetyl glucosaminidase and creatinine, in the same assays to eliminate inter-assay variability. Two independent non-diabetic cohorts of children provided urine specimens, which were stored at -20 degrees C for one cohort and -70 degrees C for the other, to determine normal ranges for urine proteins.

RESULTS

Storage at -20 degrees C led to a variable underestimation of all three urine proteins in 20% of specimens. Creatinine was unaffected. This underestimation was greater in more concentrated urine (r2 = 0.38, P < 0.001, n = 262). Consequently storage at -20 degrees C increased the variance of the albumin/ creatinine ratio more than the variance of albumin concentration. Temperature of storage affected the normal range, which was 0.1-2.1 mg/mmol at -20 degrees C compared to 0.3-3.1 mg/mmol at -70 degrees C. The prevalence of microalbuminuria (> 2SD above the geometric mean in non-diabetic specimens stored at -20 degrees C) was 27% after storage at -70 degrees C vs. 24% after -20 degrees C. The prevalence of microalbuminuria (>2SD above the geometric mean in nondiabetic specimens stored at -70 degrees C) was 21% after storage at -70 degrees C vs. 17% after -20 degrees C.

CONCLUSIONS

Urine proteins are significantly but variably underestimated after storage at -20 degrees C. These effects account for increased variance and differences in the normal range, but have less effect on the detection of microalbuminuria than might be predicted.

Comparison of urinary excretion of albumin and alpha-1-antitrypsin in patients with arterial hypertension

The aim of the presented pilot study was to compare urinary excretion of two plasma proteins similar in molecular mass and isoelectric point: albumin and alpha-1-antitrypsin (AAT) in patients with different forms of arterial hypertension and in healthy subjects. The 24-h urinary excretion of albumin and AAT were assessed in 52 patients, 29 with essential hypertension and 23 with secondary hypertension, caused by renovascular hypertension, adrenal phaeochromocytoma and obturative sleep apnoea syndrome. The concentrations of albumin and AAT were determined by rocket immunodiffusion. An increase of mean albumin and AAT urinary excretion was demonstrated, as compared to the control group, both in the patients with essential hypertension and with secondary hypertension. In 93.2% of the healthy subjects no AAT presence in urine was detected. No correlation was found between the excretion of albumin and AAT with urine.

Microalbuminuria is closely related to diabetic macroangiopathy

To investigate whether urinary excretion of transferrin (uTf) and albumin (uAlb) is related to diabetic macroangiopathy, we compared the levels of uTf and uAlb between ischemic heart disease (IHD) group and non-IHD group in patients with non-insulin-dependent diabetes mellitus. The patients (n = 102) without macroproteinuria were enrolled in the present study. Firstly, we divided the subjects into the two groups, IHD group (n = 16) and non-IHD group (n = 86), according to findings of ischemic changes on electrocardiogram. The levels of uTf and uAlb in IHD group were 3.9 +/- 0.9 and 40.6 +/- 9.7 (mean +/- S.E.M.) mg/g Creatinine, respectively. These values were significantly (P < 0.01) higher than those of non-IHD group (1.8 +/- 0.2 for uTf and 19.6 +/- 1.8 for uAlb). There was no significance in the levels of HbA1c, blood pressure, plasma lipids, and diabetic duration between the two groups. Secondly, we divided the subjects by the levels of uTf and uAlb. The frequency of IHD in the group (n = 22, 36.4%) with microalbuminuria and microtransferrinuria was significantly (P <0.03) higher than those (n = 38, 10.5%) with normoalbuninuria and microtransferrinuria, and also significantly (P < 0.02) higher than those (n = 42, 9.5%) with normoalbuminuria and normotransferrinuria. We concluded that the measurement of uAlb is important when approaching diabetic macroangiopathy.

Comparison of methods to assess airborne rat and mouse allergen levels. I. Analysis of air samples

Airborne laboratory-animal allergens can be measured by several methods, but little is known about the effects of important differences in methodology. Therefore, methods used in research projects in The Netherlands, the UK, and Sweden were compared. Seventy-four sets of three parallel inhalable dust samples were taken by a single operator in animal facilities in the three countries, and analyzed in parallel by the three institutes for rat and mouse urinary allergen. Rat-allergen levels measured by RAST inhibition (UK) were 3000 and 1700 times higher than levels measured by enzyme immunoassay (EIA)-sandwich methods with polyclonal rabbit (The Netherlands) or monoclonal mouse (Sweden) antibodies, while the difference between the two EIA-sandwich methods was much smaller: a factor of 2.2. For mouse allergen, an inhibition radioimmunoassay (RIA) with rabbit antimouse antibodies (UK) gave 4.6 and 5.9 times higher concentrations than sandwich EIAs with rabbit polyclonal antibodies (Sweden and The Netherlands), while the difference between the two sandwich EIAs was, on average, 1.6-fold. Thus, although levels of rat and mouse aeroallergens are significantly correlated, the assay type gives large differences in absolute concentrations, and interlaboratory technical differences affect even the same assay type. Conversion factors can aid comparison between studies, and, in the long term, assay standardization is desirable.

Long-term stability of albumin, protein HC, immunoglobulin G, kappa- and lambda-chain-immunoreactivity, orosomucoid and alpha 1-antitrypsin in urine stored at -20 degrees C

The stability of albumin, protein HC, immunoglobulin G, kappa- and lambda-chain immunoreactivity, orosomucoid and alpha 1-antitrypsin in urine stored at -20 degrees C for up to 24 months was investigated. Significant decreases of the median concentration values for protein HC, IgG and alpha 1-antitrypsin were observed for native urine. Addition to urine of a preservative solution containing benzamidinium chloride, EDTA, tris(hydroxymethyl)-aminomethane and azide prevented the decreases of the concentration values for protein HC and IgG but not for alpha 1-antitrypsin. The median concentration values for albumin, orosomucoid and kappa- and lambda-chain immunoreactivity did not change significantly upon storage of native urine, nor for urine with the preservative solution.

The use of the Micral-Test strip to identify the presence of microalbuminuria in people with insulin dependent diabetes mellitus (IDDM) participating in the EUCLID study

In IDDM, microalbuminuria (urinary albumin excretion rate (AER) of 20-200 micrograms/min) is a predictor of persistent proteinuria and diabetic nephropathy. Early intervention may prevent or reduce the rate of progression of renal complications. The Micral-Test strip can be used to establish a semi-quantitative estimate of AER. We assessed the field performance of the Micral-Test strip in detecting microalbuminuria in the EUCLID study, an European wide, 18 centre study of 530 IDDM participants, aged 20 to 59 years. People with macroalbuminuria were excluded. On entry, all participants had albumin concentrations from two overnight urine collections measured by a central laboratory, and the corresponding Micral-Test performed on the two collections locally. a cut off of > or = mg/l albumin from the first Micral-Test, to detect a centrally measured albumin concentration > or = 20 mg/l, yielded 29 (5.8%) false negative results and 58 (11.6%) false positive results (sensitivity 70%, specificity 87%). The mean AER, from two collections, was compared with the corresponding 'pooled' Micral-Test results (mean of the two readings). Receiver Operating Characteristic (ROC) curves were used to assess if there was a suitable 'pooled' Micral-Test result for screening microalbuminuria. A 'pooled' Micral-Test result (> or = 15 mg/l) was used to detect mean AER > or = 20 micrograms/min (sensitivity 78%, specificity 77%). This 'pooled cut-off' had already been used for screening on to the study and led to an over-estimate (154 vs. 77) of the true number of microalbuminuric participants on the study. In conclusion, our findings suggest that the Micral-Test strip is not an effective screening tool for microalbuminuria, using the 'pooled' result from two measurements did not improve the sensitivity of the test.

Urinary excretion of proteins among metal welders

Joining of metals by welding confer an exposure of dust particulates containing several toxic substances. Chromium, nickel and manganese is absorbed in the lungs and may adversely affect the renal function. We compared biological markers of glomerular filtration (Kampmann clearance) and tubular function (post-shift urine spot sample concentration of respectively albumin, immunoglobulin G, transferrin, orosomucoid and beta 2-microglobulin) among 102 ever-welders and 33 never-welders (mostly electricians). The welders were subdivided into groups of stainless steel welders (n = 35), mild steel welders (n = 46) and ex-welders (n = 21). Each group was separately referenced with never-welders. The Kampmann clearance was within normal limits in all workers and not related to welding exposure. However, the urinary concentration of the majority of proteins was 1.5 to 3.0 times higher in both stainless steel and mild steel welders. The number of welding years taken as a measure of cumulative welding exposure was not related to levels of proteins in urine when adjusting for the effect of age. In addition, no alteration of urinary proteins was found among the ex-welders apart from slightly elevated albumin. This indicates that the apparent effect of welding on renal tubular function may at least partially be reversible. In conclusion, this study is in support of the hypothesis that metal welding may adversely affect renal tubular function, but it is questionable whether welding exposure has bearings as to occurrence of clinical significant kidney disease.

Stability of albumin, protein HC, immunoglobulin G, kappa- and lambda-chain immunoreactivity, orosomucoid and alpha 1-antitrypsin in urine stored at various conditions

Urine samples from 10 randomly selected patients with advanced renal disease were each divided into six aliquots and a preservative solution containing benzamidinium chloride, EDTA, tris(hydroxymethyl)-aminomethane and azide was then added to three of the aliquots. Aliquots with and without additive were then stored at room temperature for up to 7 days, at 4 degrees C for up to 30 days and at -20 degrees C for up to 6 months. The concentrations of albumin, protein HC, IgG, orosomucoid and alpha 1-antitrypsin as well as the kappa- and lambda-chain immunoreactivities in the samples were determined by automated immunoturbidimetry or by single radial immunodiffusion after 1, 3, 7, 14, 30, 90 and 180 days of storage. All investigated proteins, except alpha 1-antitrypsin in native urine, were stable for 7 days in the samples stored at room temperature both in the presence and absence of additives. All investigated proteins, except alpha 1-antitrypsin in native urine, were stable for 30 days in the samples stored at 4 degrees C both in the presence and absence of additives. A more complex pattern was observed for the stability of the proteins in the frozen samples. The IgG level decreased rapidly in several samples stored without additives but not in samples stored with additives. The alpha 1-antitrypsin concentration decreased rapidly to about 50% of the initial value in several samples stored both with and without additives. The rate of the decrease for both the IgG and the alpha 1-antitrypsin level varied between samples and the main decrease for several samples was seemingly caused by the freezing and/or thawing per se and not by the storage period in between.