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Interest and research in urinary enzymology were incited about three decades ago by reports that urinary enzymes are elevated in diseases of the kidney and urinary tract. Of the more than 40 hydrolases, oxidoreductases, transferases, and lyases identified in human and animal urine, only ten or so are being used as diagnostic indicators. Recognition of the quantitative distribution of enzymes in the various anatomical and functional parts of the nephron and advances in our understanding of the handling of proteins by the kidney have made it possible to associate urinary enzyme activity patterns with physiological and pathophysio logical functions of the nephron. Confidence in the diagnostic value of urinary enzymes is not unanimous among clinicians and among scientists. The main reason for the difference in opinion may well be that the variability in data exceeds the variability one is accustomed to in the diagnostic enzymology of blood plasma enzymes. In contrast to plasma enzymes, which are protected by an "enzyme friendly" milieu, enzymes released into the urine encounter an "enzyme hostile" environ ment: no or little protective protein, variable pH, variable volume, variable metabolite and salt concentrations, variable concentrations of enzyme in hibitors. Through advances in methodology some of these factors can now be controlled; standardization of urine collection periods and preanalytical treat ment are as important as optimization of assay methods.
Interest and research in urinary enzymology were incited about three decades ago by reports that urinary enzymes are elevated in diseases of the kidney and urinary tract. Of the more than 40 hydrolases, oxidoreductases, transferases, and lyases identified in human and animal urine, only ten or so are being used as diagnostic indicators. Recognition of the quantitative distribution of enzymes in the various anatomical and functional parts of the nephron and advances in our understanding of the handling of proteins by the kidney have made it possible to associate urinary enzyme activity patterns with physiological and pathophysio logical functions of the nephron. Confidence in the diagnostic value of urinary enzymes is not unanimous among clinicians and among scientists. The main reason for the difference in opinion may well be that the variability in data exceeds the variability one is accustomed to in the diagnostic enzymology of blood plasma enzymes. In contrast to plasma enzymes, which are protected by an "enzyme friendly" milieu, enzymes released into the urine encounter an "enzyme hostile" environ ment: no or little protective protein, variable pH, variable volume, variable metabolite and salt concentrations, variable concentrations of enzyme in hibitors. Through advances in methodology some of these factors can now be controlled; standardization of urine collection periods and preanalytical treat ment are as important as optimization of assay methods.
Diseases of the kidney, bladder, and prostate exact an enormous human and economic toll on the population of the United States. This book examines prevention of these diseases through the development of reliable markers of susceptibility, exposure, and effect and the promise that new technologies in molecular biology and sophisticated understanding of metabolic pathways, along with classical approaches to the study of nephrotoxicants and carcinogens, can be developed and prevention of the diseases achieved. The specific recommendations included in this book complement those made in the previous three volumes on biomarkers, Biologic Markers in Reproductive Toxicology (1989), Biologic Markers in Pulmonary Toxicology (1989), and Biologic Markers in Immunotoxicology (1991).
Diseases of the kidney, bladder, and prostate exact an enormous human and economic toll on the population of the United States. This book examines prevention of these diseases through the development of reliable markers of susceptibility, exposure, and effect and the promise that new technologies in molecular biology and sophisticated understanding of metabolic pathways, along with classical approaches to the study of nephrotoxicants and carcinogens, can be developed and prevention of the diseases achieved. The specific recommendations included in this book complement those made in the previous three volumes on biomarkers, Biologic Markers in Reproductive Toxicology (1989), Biologic Markers in Pulmonary Toxicology (1989), and Biologic Markers in Immunotoxicology (1991).
**Selected for Doody's Core Titles® 2024 in Transplantation Surgery** From basic science to practical clinical tools, Chronic Kidney Disease, Dialysis, and Transplantation, 4th Edition provides you with the up-to-date, authoritative guidance you need to safely and effectively manage patients with chronic renal disease. Covering all relevant clinical management issues, this companion volume to Brenner and Rector's The Kidney presents the knowledge and expertise of renowned researchers and clinicians in the fields of hemodialysis, peritoneal dialysis, critical care nephrology, and transplantation – for an all-in-one, indispensable guide to every aspect of this fast-changing field. - Contains expanded content on economics and outcomes of treatment, as well as acute kidney injury. - Covers hot topics such as the genetic causes of chronic kidney disease, ethical challenges and palliative care, and home hemodialysis. - Discusses the latest advances in hypertensive kidney disease, vitamin D deficiency, diabetes management, transplantation, and more. - Provides a clear visual understanding of complex information with high-quality line drawings, photographs, and diagnostic and treatment algorithms. - Expert ConsultTM eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.
Also containing a bibligraphy with 1323 references.
"This 2nd edition of Critical care nephrology continues to provide comprehensive coverage of the latest advances in critical care procedures for the adult or pediatric patient with renal diseases or disorders. It presents a common language and standardized guidelines to help multi-disciplinary physicians caring for the critically ill communicate more effectively. "--BOOK JACKET.
Advances in long-term improvement and outcomes of patients with kidney disease will require the use of novel biomarkers to identify patients at high risk for kidney disease and to diagnose kidney disease early for effective treatment. A biomarker is a substance found in the blood, body fluids or tissues that provides a measure of normal biological or pathological processes or response to pharmacological compounds or drugs. There are a wide variety of biomarkers including but not limited to mRNA, proteins and peptides, and lipid molecules. In AKI, important pathophysiological processes such as inflammation, apoptotic and necrotic cell death and, tubule regeneration may be reflected in blood or urine. An array of candidate markers along with clinical information in long-term clinical studies with appropriate analytical methodologies will likely provide prognostic information. Despite well-known limitations, currently the most widely used biomarkers for the early diagnosis of CKD and AKI are proteinuria, serum creatinine and blood urea nitrogen. Most clinicians are aware that serum creatinine and blood urea nitrogen are poor biomarkers due to inherent characteristics of these molecules and handling by the kidney. Creatinine is secreted and urea nitrogen is reabsorbed by the renal tubules. Many endogenous substances interfere in the assay for creatinine. Serum creatinine and urea appear late after acute kidney injury and the serum levels in part depend on the generation (large or small body mass). Acute kidney injury is a non steady state condition thus serum creatinine and urea nitrogen will lag behind kidney injury. For these reasons new biomarkers are imperative. With knowledge of these limitations in use of current biomarkers and the lack of progress in reducing the mortality and morbidity from kidney disease, there has been a great surge of interest in identifying novel biomarkers with a particular emphasis on the early diagnosis of kidney disease. A variety of methods have been employed including transcriptomics, proteomics, gene arrays and lipidomics. Currently, candidate biomarkers have been found in different disorders and have been tested in humans and many candidate biomarkers have yet to be identified. Most studies to date are preliminary and require validation in large multicentre studies followed by commercial assay development validation and testing. This new book outlines the rapid advances made in the field of biomarker development for kidney disease in which a variety of novel molecules have been identified and studied in humans.
This book is a landmark in the continuously changing world of drugs. It is essential reading for scientists and managers in the pharmaceutical industry who are involved in drug finding, drug development and decision making in the development process.
This book discusses urinalysis in clinical laboratory practice, including a historical overview, methods, future endeavours.