title: Change in albumin measurement method affects diagnosis of nephrotic syndrome.
abstract: BACKGROUND
  Although serum albumin levels (sALB) have been quantified by the dye-binding method with bro- mocresol green (BCG) or bromocresol purple (BCP) on a routine basis, accurate measurement of sALB with these methods is difficult. The modified BCP method is highly specific to albumin without being affected by sample preservation to enable stable and accurate quantification of albumin concentrations. A change in the albumin measurement method may alter the diagnosis of nephrotic syndrome.
  
  
  METHODS
  sALB was measured in 295 patients including 98 patients with chronic renal disease by the modified BCP method, BCG method, and immunonephelometry as the gold standard.
  
  
  RESULTS
  sALB measured by the modified BCP method was well correlated with levels measured by immunonephelometry. sALB obtained by the BCG method was significantly higher than the levels measured by the modified BCP method (p < 0.001, Student's t-test). This tendency was more evident in patients with chronic renal disease than other patients. When the threshold value of sALB for the diagnosis criteria of nephrotic syndrome (≤ 25 g/L) and a high risk of thrombosis (≤ 20 g/L) in nephrotic syndrome was based on the BCG method, the revised criteria in the modified BCP method would be ≤ 20.5 and ≤ 14.9 g/L, respectively.
  
  
  CONCLUSIONS
  Overestimation of sALB by the BCG method affected diagnosis of nephrotic syndrome. The method by which sALB is measured should be specified in both clinical and research settings in nephrology.
authors: Masanori
authors: M
authors: Seimiya
authors: Sayaka
authors: S
authors: Ohno
authors: Haruna
authors: H
authors: Asano
authors: Keiko
authors: K
authors: Fujiwara
authors: Toshihiko
authors: T
authors: Yoshida
authors: Yuji
authors: Y
authors: Sawabe
authors: Kazuyuki
authors: K
authors: Sogawa
authors: Makoto
authors: M
authors: Ogawa
authors: Kazuyuki
authors: K
authors: Matsushita
authors: Osamu
authors: O
authors: Yokosuka
authors: Fumio
authors: F
authors: Nomura
mesh_terms: D015415:Biomarkers / Q000097:blood; D001961:Bromcresol Green; D001962:Bromcresol Purple; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis*; D009391:Nephelometry and Turbidimetry; D009393:Nephritis / Q000097:blood / Q000175:diagnosis*; D009404:Nephrotic Syndrome / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis*; D000075462:Serum Albumin, Human
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D012709:Serum Albumin; D001962:Bromcresol Purple; D001961:Bromcresol Green; D000075462:Serum Albumin, Human