Diagnosis of renal proximal tubular injury by urinary immunoassay for a proximal tubular antigen, the adenosine deaminase binding protein

N. E. Tolkoff-Rubin, R. E. Thompson, D. J. Piper, W. P. Hansen, N. H. Bander, C. Cordon-Cardo, C. J. Finstad, L. H. Klotz, L. J. Old, R. H. Rubin

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

A sandwich ELISA assay has been formatted from two commercially available murine monoclonal antibodies, URO-4 and URO-4a, directed against a 120 000 dalton glycoprotein, the adenosine deaminase binding protein (ABP), found on the brush border of the renal proximal tubular epithelial cell. Untimed urine samples from 37 normal individuals and urinary ABP <0.1 AU; 37 patients with pure glomerular disease had ABP <0.4 AU (with 29, or 76% <0.2 AU); 10 patients with pre-renal azotaemia had ABP <0.6 (with 8, or 80% <0.3 AU). In contrast, 79 patients with post-ischaemic acute tubular necrosis had ABP >0.6 AU. Acute renal failure due to myoglobinuria, contrast dye, and aminoglycoside toxicity were all associated with urinary ABP >1.0 AU. In addition, all six patients with acute bacteraemic pyelonephritis had ABP >0.7 AU, as opposed to ABP <0.2 AU in the urines of 12 women with acute cystitis. We conclude that this monoclonal antibody based urinary assay is a sensitive measure of renal proximal tubular injury, reliably distinguishes acute tubular from glomerular disease, and may be helpful in differentiating forms of urinary tract infection.

Original languageEnglish
Pages (from-to)143-148
Number of pages6
JournalNephrology Dialysis Transplantation
Volume2
Issue number3
StatePublished - 1987
Externally publishedYes

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