Development and performance of an albumin-creatinine ratio assay on the afinion as100 analyzer request pdf gastroenterology


Background: Diabetic nephropathy is one of the most serious and most frequent secondary complications of diabetes mellitus, resulting in increased morbidity and mortality rates. Microalbuminuria is the earliest stage of diabetic nephropathy and is characterized by a persistent and significant elevation in urinary albumin excretion. When quantifying urine proteins, creatinine measurements are used to correct for varying diuresis because creatinine is produced at an approximately constant rate.

Methods: The Afinion AS100 Analyzer is a compact, benchtop gas line jobs in wv, multiassay analyzer for point-of-care testing. The Afinion ACR assay presented here analyzes both the albumin and creatinine levels in a urine sample simultaneously within a single device. Albumin is quantified using an immunometric membrane flow through assay, using monoclonal antibody-coated membrane and monoclonal antibodies conjugated to colloidal gold. Creatinine is quantified using an enzymatic colorimetric test involving 4 enzymatic electricity in india ppt steps. At analysis completion, the concentrations of albumin, creatinine, and albumin-creatinine ratio (ACR) are shown on the Afinion AS100 Analyzer display screen.

Results: Measurement ranges are 5 to 200 mg/L (albumin) and 16 to 340 mg/dL (creatinine). Both assays are linear over the whole dynamic range. Comparison of Afinion with Siemens DCA2000 and Roche Modular using 95 samples resulted in a linear correlation coefficient (r) of 0.99 for albumin (both methods) and 0.99 and 1.00, respectively, for creatinine. Total imprecision is 5.5% or lower for albumin, 3.8% or lower for creatinine, and 6.0% or lower for ACR.

We describe a new colorimetric method for measuring creatinine in serum and urine. Creatinine hydrolysis is catalyzed by creatinine amidohydrolase, and the creatine so produced is assayed in reactions catalyzed sequentially by creatine amidinohydrolase and sarcosine oxidase in a system that generates hydrogen peroxide. The hydrogen peroxide is measured at 510 nm in a reaction catalyzed by horseradish peroxidase, with 3,5-dichloro-2-hydroxybenzenesulfonic acid/4-aminophenazone as the chromogen. This series of reactions is complete in 30 min at room temperature. A blank electricity consumption sample measurement corrects for endogenous creatine. The standard curve is linear for creatinine concentrations as great as 2.21 mmol/L. Analytical recovery of creatinine in human sera and urine averaged 99.8%. Within-run and between-run precision studies gave CVs of less than or equal to 3.3 and less than or equal to 4.3% for a serum with a creatinine concentration of 69 mumol/L. Results by this method agree well (r greater than 0.99) with those by both the enzymic ultraviolet method of Wahlefeld and the fuller’s earth/Jaffé method.

Microalbuminuria is associated with both an increased prevalence of cardiovascular risk factors and greater renal and cardiovascular morbidity. We questioned whether in the general population such associations can be found at lower levels of urinary albumin excretion than that of classically defined microalbuminuria. To that purpose urinary albumin concentration was measured in 40619 subjects aged 28 to 75 years. The subjects filled in a questionnaire on cardiovascular risk factors and events and were divided in deciles according to their urinary albumin concentration. Smoking was associated with albuminuria in the fifth or higher decile of urinary albumin concentration, that is with an albumin concentration of 5.1 mg/l and higher. The lower cut-off point for physics electricity and magnetism study guide a positive association with hypertension was 8.8 mg/l, and for diabetes 11.2 mg/l. Family history for cardiovascular disease and hyperlipidaemia were not associated with albuminuria. We conclude that urinary albumin concentrations far below the microalbuminuric range are associated with increased prevalence of established cardiovascular risk factors. Family history for cardiovascular disease and hyperlipidaemia seems to behave differently. These data emphasize the need for more studies on the impact of albuminuria on the prediction of cardiovascular and renal disease in the general population.

An accurate method to assess albuminuria in pregnancy is mandatory to diagnose pre-eclampsia. Twenty-four-hour urine collection is still the only universally accepted method. This is, however, a cumbersome and inconvenient method gas quality by brand. Therefore, the present study aimed at assessing the accuracy of a spot urine albumin/creatinine ratio in pregnant women with hypertension.

In 54 pregnant women with blood pressure or=140/90 mmHg, 24-h albumin excretion and subsequent albumin/creatinine ratio on morning spot urine were analyzed in the individual patients. Altogether 75 paired samples were included. Receiver operating characteristic curves, relating different albumin/creatinine ratio cut-off values to 24-h albumin excretion 300 mg were constructed. Correlations were assessed by Spearman rank correlation tests.

The area under the receiver operating characteristic curve was 0.985. At the optimal cut-off albumin/creatinine ratio value of 27 mg/mmol the gas x strips directions sensitivity, specificity, positive and negative predictive value for detecting albuminuria 300 mg/24 h were: 95, 100, 100 and 86% respectively. There was a close correlation between albumin/creatinine ratio and 24-h albumin excretion values (r=0.95; p0.001).

A total of 88 spot urine samples previously analyzed using the Vitros 5,1 FS (creatinine) and Beckman Coulter Immage (microalbumin) located in the … [Show full abstract] central laboratory and having microalbumin and creatinine values within the Afinion and DCA Vantage reportable ranges were run on 2 point of care (POC) instruments (Siemens DCA Vantage and Axis-Shield Afinion).

The mean values for the DCA Vantage were: 42.6 mg/l for albumin, 10.3 mol/l for creatinine, and 5.4 mg/mol for ACR. For the Afinion AS100, the mean values were: 48.5mg/l for albumin, 9.5 mol/l for creatinine, and 6.7 mg/mol for ACR. The mean values obtained for CL were: 40.8 mg/l for albumin, 10.0 mol/l for creatinine, and 5.4 mg/mol for ACR. All POC analyzers showed good correlation to the central laboratory tests for microalbumin, creatinine and albumin creatinine ratio (ACR) for Afinion (R(2)=0.954, 0.974, and 0.964, respectively) and DCA Vantage (R(2)=0.989, 0.987, and 0.991, respectively). With the exception of the DCA Vantage ACR (p=0.53), the levels of microalbumin, creatinine and ACR obtained for gaslighting examples the Afinion and DCA Vantage instruments as compared to the CL were statistically different (p0.05). The inter and intraday imprecision for both POC instruments was 2.9% and total imprecision 8.7%.

The American Diabetes Association and the National Kidney Foundation define microalbuminuria as an albumin (μg)/creatinine (mg) ratio (ACR) between 30 and 300 μg/mg regardless of sex. Microalbuminuria is associated with increased cardiovascular risk. The authors evaluated the prevalence of microalbuminuria in nondiabetic and nonhypertensive systolic heart failure (SHF) patients. Twenty-seven SHF … [Show full abstract] patients, 18 years and older, with New York Heart Association functional classes II through IV and left ventricular ejection fraction ≤40%, who were nondiabetic and nonhypertensive and not receiving angiotensin-converting enzyme inhibitors, were selected. Twenty-seven healthy individuals, paired j gastrointest surg according to sex, ethnicity, and age, were used as controls. Early-morning midstream urine was used. Data are expressed as medians. Excretion of albumin in SHF patients cheapest gas in texas (39 μg/mL urine) was significantly higher than in controls (26 μg/mL urine). Creatinine excretion was not significantly different between patients and controls. ACR was significantly higher in patients (54 μg/mg) than in controls (24 μg/mg). The results indicate that microalbuminuria was significantly present in nondiabetic and nonhypertensive SHF patients. Read more

Diabetic nephropathy is a long-term complication of diabetes that is associated with progressive renal failure as well as an increased risk for cardiovascular disease. Microalbuminuria is an accepted predictive marker for the early detection of impending renal disease in diabetic patients. The authors carried out a prospective, pragmatic study of the analytic, clinical, and cost-effectiveness … [Show full abstract] aspects of a microalbumin point-of-care (POC) device in the diabetic clinic setting in comparison with the central laboratory method of quantification. Different testing strategies and their associated costs were then evaluated. In comparison with the central laboratory quantification, POC estimations of albumin and creatinine agreed to within one detection band in 91.8% and 82.6% of results respectively. The POC albumin-to-creatinine ratio was in agreement with the laboratory estimations in 89.7% of cases. Sample turnaround time was reduced markedly, and 93% of responding clinician’s found the service useful. A modeled screening strategy using the POC device to select abnormal samples for formal quantification by the central laboratory resulted in a 58% reduction in laboratory microalbumin testing workload while retaining a high sensitivity (98.4%) and maximum specificity (100%). The POC results were in good agreement with gas in dogs symptoms the quantitative laboratory results. This test may therefore be used as a first-line screening tool that cuts central laboratory workload and accelerates the confirmation of microalbuminuria in diabetic patients. Read more Discover more