Estimation of Creatinine by the Jaffe Reaction A Comparison of Three Methods
01 Mar 1968-Clinical Chemistry (American Association for Clinical Chemistry)-Vol. 14, Iss: 3, pp 222-238
TL;DR: Total chromogen, true, and AutoAnalyzer methods of measuring serum and urine creatinine by the Jaffe reaction were investigated and their precision, recovery, and sample stability determined.
Abstract: Total chromogen, true, and AutoAnalyzer methods of measuring serum and urine creatinine by the Jaffe reaction were investigated. Some factors influencing this reaction were examined. These included wavelength, blank, linearity, and conditions of color development. Modifications of the three methods were made and their precision, recovery, and sample stability determined. The interference of ketones and glucose were measured. Finally, the values obtained by the three methods on the same samples of serum and urine were compared statistically.
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TL;DR: Elevated levels of microalbuminuria strongly predict the development of clinical diabetic nephropathy, and these levels of AER are potentially reversible, and their detection and treatment may prevent diabetic renal disease.
Abstract: The overnight urinary albumin excretion rate (AER) of 87 patients with insulin-dependent diabetes mellitus was measured in 1966-67, 14 years later information was obtained on 63 of the original cohort; those alive were restudied, and for those who had died relevant clinical information and case of death were recorded. The development of clinical diabetic nephropathy ('Albustix'positive proteinuria) was related to the 1966-67 AER values. Clinical proteinuria developed in only 2 of 55 patients with AER below 30 microgram/min but in 7 of 8 with AER between 30 and 140 microgram/min. The risk of clinical diabetic nephropathy in the latter group was twenty-four time higher than inthe former. 9.1% of patients with AER below 30 microgram/min had died, compared with 37.5% with higher AER. The two groups did not differ significantly in age, sex composition, and initial blood pressure. Mean duration of diabetes was longer, but not significantly so, in those with AER above 30 microgram/min. Thus, elevated levels of microalbuminuria strongly predict the development of clinical diabetic nephropathy. These levels of AER are potentially reversible, and their detection and treatment may prevent diabetic renal disease.
1,665 citations
TL;DR: It is concluded that the determination of the protein/creatinine ratio in single urine samples obtained during normal daylight activity, when properly interpreted by taking into consideration the effect of different rates of creatinine excretion, can replace the 24-hour urine collection in the clinical quantitation of proteinuria.
Abstract: Quantitation of urinary protein excretion is used extensively for diagnostic and prognostic purposes and to assess the effects of therapy. The method most commonly used to measure urinary protein relies on 24-hour urine collections, which are time consuming, cumbersome, and often inaccurate. We reasoned that the urinary protein/creatinine ratio in a single voided urine sample should correlate well with the quantity of protein in timed urine collections. In a study of 46 specimens we found an excellent correlation between the protein content of a 24-hour urine collection and the protein/creatinine ratio in a single urine sample. The best correlation was found when samples were collected after the first voided morning specimen and before bedtime. We conclude that the determination of the protein/creatinine ratio in single urine samples obtained during normal daylight activity, when properly interpreted by taking into consideration the effect of different rates of creatinine excretion, can replace the 24-hour urine collection in the clinical quantitation of proteinuria. In the presence of stable renal function, a protein/creatinine ratio of more than 3.5 (mg/mg) can be taken to represent "nephrotic-range" proteinuria, and a ratio of less than 0.2 is within normal limits.
739 citations
TL;DR: This study shows that the major CGA compounds present in green coffee are highly absorbed and metabolized in humans.
Abstract: Chlorogenic acids (CGA) are cinnamic acid derivatives with biological effects mostly related to their antioxidant and antiinflammatory activities. Caffeoylquinic acids (CQA) and dicaffeoylquinic acids (diCQA) are the main CGA found in nature. Because green coffee is a major source of CGA, it has been used for production of nutraceuticals. However, data on the bioavailability of CGA from green coffee in humans are inexistent. The present study evaluated the pharmacokinetic profile and apparent bioavailability of CGA in plasma and urine of 10 healthy adults for 8 h after the consumption of a decaffeinated green coffee extract containing 170 mg of CGA. Three CQA, 3 diCQA, and caffeic, ferulic, isoferulic, and p-coumaric acids were identified in plasma by HPLC-Diode Array Detector-MS after treatment. Over 30% (33.1 +/- 23.1%) of the ingested cinnamic acid moieties were recovered in plasma, including metabolites, with peak levels from 0.5 to 8 h after treatment. CGA and metabolites identified in urine after treatment were 4-CQA, 5-CQA, and sinapic, p-hydroxybenzoic, gallic, vanillic, dihydrocaffeic, caffeic, ferulic, isoferulic, and p-coumaric acids, totaling 5.5 +/- 10.6% urinary recovery of the ingested cinnamic and quinic acid moiteties. This study shows that the major CGA compounds present in green coffee are highly absorbed and metabolized in humans.
513 citations
Cites methods from "Estimation of Creatinine by the Jaf..."
...Urinary creatinine was measured by the Jaffe reaction, as previously described (16)....
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TL;DR: Substantial EPL was demonstrated in the non-clinically pregnant cycles and a positive relation between EPL and subsequent fertility was demonstrated.
Abstract: Objective To examine rates of conception and pregnancy loss and their relations with time to clinical pregnancy and reproductive outcomes. Design A prospective observational study. Setting Population-based cohort in China. Patient(s) Five hundred eighteen healthy newly married women who intended to conceive. Upon stopping contraception, daily records of vaginal bleeding and daily first-morning urine specimens were obtained for ≤1 year or until a clinical pregnancy was achieved. Daily urinary hCG was assayed to detect early pregnancy loss (EPL). Intervention(s) None. Main outcome measure(s) Conception, pregnancy loss, and time to clinical pregnancy. Result(s) The conception rate per cycle was 40% over the first 12 months. Of the 618 detectable conceptions, 49 (7.9%) ended in clinical spontaneous abortion, and 152 (24.6%) in EPL. Early pregnancy loss was detected in 14% of all the cycles without clinically recognized pregnancy, but the frequencies were lower among women with delayed time to clinical pregnancy. Early pregnancy loss in the preceding cycle was associated with increased odds of conception (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.8–3.9), clinical pregnancy (OR, 2.0; 95% CI, 1.3–3.0), and EPL (OR, 2.4; 95% CI, 1.4–4.2) but was not associated with spontaneous abortion, low birth weight, or preterm birth in the subsequent cycle. Conclusion(s) We demonstrated substantial EPL in the non–clinically pregnant cycles and a positive relation between EPL and subsequent fertility.
499 citations
TL;DR: Elevated nonfasting plasma tHcy levels are independently associated with increased rates of all-cause and CVD mortality in the elderly.
Abstract: Background Elevated fasting total homocysteine (tHcy) levels were recently shown to confer an independent risk for all-cause and cardiovascular disease (CVD) mortality among selected Norwegian patients with confirmed coronary heart disease We examined whether elevated fasting plasma tHcy levels were predictive of all-cause and CVD mortality in a large, population-based sample of elderly US women and men Methods Nonfasting plasma tHcy levels were determined in 1933 elderly participants (mean age, 70 ± 7 years; 589% women) from the original Framingham Study cohort, examined between 1979 and 1982, with follow-up through 1992 Unadjusted and adjusted (ie, for age, sex, diabetes, smoking, systolic blood pressure, total and high-density lipoprotein cholesterol, and creatinine) relative risk estimates (with 95% confidence intervals [CIs]) for total and CVD mortality were generated by proportional hazards modeling, with tHcy levels (quartiles) as the independent variable Results There were 653 total deaths and 244 CVD deaths during a median follow-up of 100 years Proportional hazards modeling revealed that tHcy levels of 1426 µmol/L or greater (the upper quartile), vs less than 1426 µmol/L (the lower three quartiles), were associated with relative risk estimates of 218 (95% CI, 186-256) and 217 (95% CI, 168-282) for all-cause and CVD mortality, respectively The relative risk estimates after adjustment for age, sex, systolic blood pressure, diabetes, smoking, and total and high-density lipoprotein cholesterol levels attenuated these associations, but they remained significant: 154 (95% CI, 131-182) for all-cause mortality; 152 (95% CI, 116-198) for CVD mortality Conclusion Elevated nonfasting plasma tHcy levels are independently associated with increased rates of all-cause and CVD mortality in the elderly
334 citations
Cites methods from "Estimation of Creatinine by the Jaf..."
...Total and HDL cholesterol levels were assessed from fresh, nonfasting plasma samples by standard Lipid Research Clinics techniques,(8) and creatinine level was measured in nonfasting plasma samples by the Jaffe method.(10) Diabetes was operationally defined as use of insulin preparations or oral hypoglycemic agents, or any recorded blood glucose level of 11....
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References
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2,005 citations
"Estimation of Creatinine by the Jaf..." refers background or methods in this paper
...Although Bonsnes and Taussky (6) suggest that a stable color is obtained with blood filtrates after 15 mm....
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...Bonsnes and Paussky (6) indicated that this time depends upon the concentration of both the NaOH and picric acid....
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...These data, contrary to the experience of Taussky (18), indicate that thymol (300 mg. per 24-hr. urine collection) is satisfactory for preserving urine creatinine....
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...Although Bonsnes and Taussky (6) suggest that a stable color is obtained with blood filtrates after 15 mm., this is not generally true with serum filtrates measured by other methods....
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...Bonsnes and Paussky (6) indicated that this time depends upon the concentration of both the NaOH and picric acid....
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563 citations
"Estimation of Creatinine by the Jaf..." refers background or methods in this paper
...It is of interest that Stevens and Skeggs, as quoted by Chasson (24), also found a close agreement between the P.C. and A.A. values....
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...The data in the present paper confirm the findings of Chasson et at. that, in urine, the P.C. values are significantly greater than the A.A. values....
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...Chasson et at....
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...Chasson, A. L., Grady, H. J., and Stanley, M. A., Determination of creatinine by means of automatic chemical analysis....
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...It is of interest that Stevens and Skeggs, as quoted by Chasson (24), also found a close agreement between the P....
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507 citations
TL;DR: Although clearance measurements offer the best means of detecting definite impairment of renal excretory function, the wide range of normal values limits the usefulness of such measurements in detecting lesser amounts of renal damage.
Abstract: The normal values for the plasma concentration, excretion and twenty-four hour endogenous clearance of creatinine are given. Thirty men and thirty women were studied and in fifteen of each sex, measurements of both creatinine and true creatinine in the plasma were made. The non-creatinine chromogen did not influence the variability of the plasma values within a single individual or among a group of individuals. Correlation analyses revealed that the sex difference in plasma concentration and clearance could be removed by correcting for lean body weight. In ten additional subjects, there was no difference in one hour clearance values measured in the morning and afternoon, but these values did exceed the twenty-four hour values by some 7 to 11 per cent. In eighty patients with evidence of renal disease, it was found that if the plasma creatinine was less than 1.25 mg.100ml. in men and less than 1.1 mg.100ml. in women, the clearance value is normal unless the patient has extensive muscular wasting. If the plasma concentration is 1.25 to 1.75 mg.100ml. in men or 1.1 to 1.4 mg.100ml. in women, the clearance may vary from definitely low to normal values. With values greater than 1.1.75 mg.100ml. in men and 1.4 mg.100ml. in women, the clearance is always low. Comparable relationships exist with true creatinine measurements. It is concluded that clearance measurements should be made and reliance not placed on the value predicted from the concentration of true creatinine in the plasma. The variability of the values in patients with evidence of renal disease was no greater for creatinine than for true creatinine measurements, and the information provided with each method was in close agreement. Either method is suitable for clinical purposes but a preference is expressed for true creatinine measurements if the plasma values are low normal or less. It is concluded that restrictive measures designed to minimize the variability resulting from changes in diet and the amount of physical activity are not justified. Similarly, corrections for surface area and lean body weight improve the normal values but are of limited usefulness in patients with evidence of renal disease. Creatinine formation in the body is briefly reviewed and instances of diminished production are commented on. Although clearance measurements offer the best means of detecting definite impairment of renal excretory function, the wide range of normal values limits the usefulness of such measurements in detecting lesser amounts of renal damage. Particular emphasis is therefore placed on the value of serial determinations in uncovering early renal impairment and in evaluating borderline values as well as the patient's prognosis and the influence of therapy. The opinion is expressed that one hour clearance measurements provide information as useful as that obtained when twenty-four hour urine collections are used.
378 citations