Invecchiamento e funzionalità renale: indagine prospettica in una coorte di soggetti anziani in buone condizioni di salute

Giorgia Fontana*, Cataldo Abaterusso, Alessandro Sorio, Francesco Fantin, Giovanni Gambaro, Mauro Zamboni, Paolo Rizzotti, Maria Stella Graziani

*Divisione di Geriatria e Divisione di Nefrologia, Università degli Studi, Verona

Biochimica Clinica: 2008; 32(6): 547-553 [Article in italian]

ABSTRACT
Aging and renal function: a longitudinal study in healthy elderly subjects. Renal function assessment is pivotal for an early identification of renal impairment. Aim of this study was to prospectively evaluate the renal function in a population of elderly healthy subjects using endogenous serum substances to estimate glomerular filtration rate (GFR). 91 women aged 72 ± 2.4 years with a body mass index (BMI) of 26.3 ± 4.4 kg/m² and 62 men aged 72.5± 2.3 years with a BMI of 27.0 ± 3.4 kg/m² were studied at baseline and after five years of follow-up. The participants were healthy and had physiological serum creatinine concentrations. The body composition was assessed by dual-energy x-ray absorptiometry (DXA). Serum creatinine, cystatin C, high sensitivity C-reactive protein, lipids, insulin, and albumin were also measured. Five GFR prediction formulas (Cockcroft-Gault, MDRD, Virga, Taylor, Hoek) utilizing serum creatinine or cystatin C were used. During the follow-up, a significant decrease in total and appendicular fat free mass (FFM) and in serum creatinine concentrations was observed, whereas cystatin C concentrations increased in both genders. Among GFR prediction formulas, only Hoek's formula, which utilises cystatin C, showed a significant decrease in GFR during the follow-up. With aging serum creatinine concentrations do not seem to correlate with kidney function due to the age-related FFM decrease. The GFR prediction formulas using serum creatinine values are not accurate in healthy elderly subjects with normal renal function. This study seems to suggest the use of cystatin C in the assessment of renal function in the elderly, considering its independence from age-related body composition changes.

Confronto tra due sistemi per elettroforesi capillare e in gel d'agarosio per la ricerca e caratterizzazione di componenti monoclonali nel siero

Ilenia Infusino, Alberto Dolci, Mauro Panteghini

Laboratorio Analisi Chimico Cliniche, Ospedale “Luigi Sacco” e Cattedra di Biochimica Clinica e Biologia Molecolare Clinica, Dipartimento di Scienze Cliniche, Università degli Studi, Milano

Biochimica Clinica: 2008; 32(6): 554-558 [Article in italian]

ABSTRACT
Comparison of capillary and agarose gel electrophoresis for the identification and characterization of monoclonal immunoglobulins. The aim of this study was to compare the performance of two systems for agarose gel (AGE) and capillary (CZE) serum protein electrophoresis (SAS3/4/5 Alfa Wassermann and Paragon CZE 2000 Beckman Coulter) for the detection and characterization of monoclonal immunoglobulins (M proteins). Two independent persons reviewed 960 consecutively ordered serum protein electrophoresis patterns, 79 (8.2%) of which showed one or more M proteins at immunofixation. For M protein detection, we found similar sensitivities for AGE and CZE (89.9% vs. 94.9%, P = 0.368), with AGE showing high specificity than CZE (99.3% vs. 96.3%, P <0.0001). With regards to M protein characterization, performed on a series of 41 consecutive samples (25 of which positive for M proteins), agreement between methods was 97.6%. A good correlation (r2 = 0.947) was found when the two methods were compared for M protein quantitation (n = 180), even if a more pronounced bias was noted with M protein concentrations >25 g/L. In agreement with previously published studies, we conclude that both AGE and CZE techniques can be used in clinical laboratories for M protein detection and characterization, even if the detection specificity of AGE as a screening test is higher.

Miglioramento dell'efficacia del trattamento con buprenorfina e dell'adesione al piano terapeutico attraverso la determinazione delle concentrazioni urinarie del farmaco

Lucio Marchioro*, Alessandra Marin, Andrea Vendramin, Mario Plebani

*Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera, Padova

Biochimica Clinica: 2008; 32(6): 559-563 [Article in italian]

ABSTRACT
Improvement of the effectiveness of buprenorphine treatment by determination of its urinary concentrations.An automated immunoenzymatic method in homogeneus phase [cloned enzyme donor immunoassay (CEDIA)] was used to detect urinary buprenorphine in a group of heroin addicts treated with the drug at different dosages. A good analytical performance was obtained with this method in comparison with the ELISA methods reported in literature, although some cross-reactivity should be considered if some opiate substances, such as methadone and morphine, are present in urine at high concentrations.

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