[Alpha 1-microglobulin in the urine and serum in proteinuria and kidney insufficiency].
Alpha-1-microglobulin (alpha-1-m) is a low molecular weight glycoprotein (mw 25-33 KD) that is filtered through the glomeruli and reabsorbed in the proximal parts of the renal tubules where it is catabolized. Normal ranges were established for alpha-1-m (100 healthy controls) in serum (20-42 mg/l) and urine (3.5-8 mg/l). Alpha-1-m was then measured in 341 urine samples whose protein pattern had been classified as "pathologic" and "normal" according to microelectrophoresis. Increased alpha-1-m concentrations were found in 266 out of 280 pathologic urines (5% false negative) and in 3 out of 61 normal urines (4% false positive). Beta-2-microglobulin (beta-2-m), total protein or protein test strips showed a poorer correlation to the electrophoretic results. Measurement of alpha-1-m is, therefore, the most sensitive of these methods for the detection of proteinuria. In 90 patients with low molecular weight proteinuria and either with or without renal insufficiency alpha-1-m concentrations were determined in both urine and serum. While all patients had elevated urinary alpha-1-m concentrations, increased serum values were only found in renal insufficiency (Ccrea less than 100 ml/min). Independently of these results, we were also able to establish that increased alpha-1-m levels are found at decreased glomerular filtration rates (Ccrea less than 70 ml/min). Pathologic alpha-1-m concentrations therefore only allow the conclusion of isolated tubular impairment when the GFR is greater than 70 ml/min.(ABSTRACT TRUNCATED AT 250 WORDS)
Weber
M H
MH
Scholz
P
P
Stibbe
W
W
Scheler
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000510:Alpha-Globulins / Q000032:analysis* / Q000652:urine; D002648:Child; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D005779:Immunodiffusion; D007674:Kidney Diseases / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D007841:Latex Fixation Tests; D008875:Middle Aged; D008970:Molecular Weight; D011507:Proteinuria / Q000378:metabolism*; D012016:Reference Values; D001613:beta 2-Microglobulin / Q000032:analysis / Q000652:urine
D000510:Alpha-Globulins; C016001:alpha-1-microglobulin; D001613:beta 2-Microglobulin; D003404:Creatinine
Alpha-1-Mikroglobulin in Urin und Serum bei Proteinurie und Niereninsuffizienz.