title: Immunoassays for serum and urine myoglobin: myoglobin clearance assessed as a risk factor for acute renal failure.
abstract: We compared four immunoassays for serum and urine myoglobin. Within-run CVs were 5-13%, with biases seen between assays. Myoglobin was stable for 1 month in serum and 12 days in urine when the pH was adjusted to between 8.0 and 9.5. Hemoglobin caused no interference. We assayed 91 pairs of serum and timed urine specimens from 41 patients admitted for acute trauma or rhabdomyolysis. Most were treated with mannitol and alkalinization. Upon initial presentations, 21 patients with either low serum myoglobin concentrations (< 400 micrograms/L) or high myoglobin clearances (> or = 4 mL/min) had normal creatinine clearances and no clinical evidence of renal disease. The remaining 20 had low myoglobin clearances. Seven were in rhabdomyolysis-induced acute renal failure, or subsequently developed this complication. We suggest that low myoglobin clearance may indicate a high risk for developing renal failure or may be an early marker for kidney dysfunction. Low myoglobin clearance may prove useful in indicating failure of prophylactic treatment to clear myoglobin.
authors.affiliation: Clinical Chemistry Laboratory, Hartford Hospital, CT 06102.
authors.forename: A H
authors.initials: AH
authors.lastname: Wu
authors.forename: I
authors.initials: I
authors.lastname: Laios
authors.forename: S
authors.initials: S
authors.lastname: Green
authors.forename: T G
authors.initials: TG
authors.lastname: Gornet
authors.forename: S S
authors.initials: SS
authors.lastname: Wong
authors.forename: L
authors.initials: L
authors.lastname: Parmley
authors.forename: A S
authors.initials: AS
authors.lastname: Tonnesen
authors.forename: B
authors.initials: B
authors.lastname: Plaisier
authors.forename: R
authors.initials: R
authors.lastname: Orlando
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000378:metabolism*; D004355:Drug Stability; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007118:Immunoassay / Q000706:statistics & numerical data; D008297:Male; D008353:Mannitol / Q000627:therapeutic use; D008657:Metabolic Clearance Rate; D009211:Myoglobin / Q000097:blood / Q000378:metabolism*; D009212:Myoglobinuria / Q000652:urine; D011786:Quality Control; D012016:Reference Values; D012206:Rhabdomyolysis / Q000150:complications / Q000378:metabolism; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D014947:Wounds and Injuries / Q000378:metabolism
chemical_list: D009211:Myoglobin; D008353:Mannitol