Optical method for screening and a new proteinuria focus group

Alar Sünter
Tartu University Hospital, Estonia

Aleksander Frorip
AS Ldiamon, Tartu Science Park, Estonia

Vadim Korsakov
Jeko Disain OÜ, Tartu, Estonia

Remo Kurruk
Tartu, Family Medicine Providers Mõisavahe Centre, Estonia

Artur Kuznetsov (Login required)
AS Ldiamon, Tartu Science Park, Estonia

Mai Ots-Rosenberg
Tartu University Hospital, Estonia

Paper #2803 received 2015.12.07; revised manuscript received 2015.12.25; accepted for publication 2015.12.30; published online 2016.02.02.

DOI: 10.18287/JBPE-2015-1-4-236


The detection of small quantities of proteinuria has gained significance as multiple studies have demonstrated its diagnostic, pathogenic, and prognostic importance. More than 260 samples of urine taken from the patients suffering chronic kidney disease (CKD), diabetes and hypertension have been analysed in the certified laboratory, with urine analyser H-50 (urine test strips) and with an optoelectronic set-up specially designed for this study. Albumin, protein and creatinine concentrations have been determined in the laboratory and the data thoroughly analysed with the aim to find new approaches to tackle the lowered level proteinuria problems. Special attention has been paid to a particular screening focus group of 16 patients all having normal or slightly abnormal levels of albumin in parallel with enhanced levels of total protein (45% cases) up to 0.4 g/L. A fair correlation between the maxima in the protein, protein/creatinine, protein/albumin values and CKD in the focus group has been observed. The urine test strips method gave 94% negative false results for the focus group whereas the new sensor has shown in all cases the presence of proteins. The sensor signals higher than the mean in this focus group were obtained for the donors with the diagnosed CKD and some other diseases. The new method is based on the optical absorption measurements (285 nm) in the protein fractions received with use of the commercial desalting columns PD-10. The method can be applied in the wide region of protein concentrations from ≤0.1 g/L up to the levels of severe proteinuria (~10g/L).


albuminuria; screening; Tamm-Horsfall protein; Bence-Jones protein; diabetic nephropathy

Full Text:



1. K. Matsushita, M. van der Velde, B. C. Astor, M. Woodwart, A. S. Levey, P. E. de Jong, J. Coresh, and R. T. Gansevoort, “Association of estimated GFR and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis,” The Lancet 375(9731), 2073-2081 (2010).

2. KDIGO Clinical Practice Guideline of CKD, Kidney International Supplements 3, (2013).

3. M. Rosenberg, and Ü. Pechter, “Microalbuminuuria – südame- ja veresoonkonnahaiguse riski näitaja,” Eesti arst, 86(7), 470-473 (2007).

4. KDIGO Guideline for the Care of Kidney Transplant Recipients.

5. G. Pittman, “Evidence lacking on screening for kidney disease,” Reuters Health, 27 August. 2012.

6. R. T. Gansevoort, K. Matsushita, M. van der Velde, B. C. Astor, M. Woodward, A. S. Levey, P. E. de Jong, and J. Coresh, “Lower estimated GFR and albuminuria associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts,” Kidney Int. 80(1), 93-104 (2011). Crossref

7. J. A. Simerville, M. C. Maxted and J. J. Pahira, “Urinalysis: A Comprehensive Review,” Am. Family Physician 71(6), 1153-1162 (2005).

8. J. Dube, J. Girouard, P. Leclerc, and P. Douville, “Problems with the estimation of urine protein by automated assays,” Clin. Biochemistry 38(5), 479-485 (2005). Crossref

9. P. L. Lynch, J. Savory, and D. M. Haverstick, “Urine total measurement with the Vitros dry reagent technology: modification of diluent to resolve positive bias of diluted samples,” Clin. Chem. 44(3), 674-675 (1998).

10. R. E. Chambers, D. G. Bullock, and J. T. Whicker, “Urinary total protein estimation – fact or fiction?” Nephron 53(1), 33-36 (1989). Crossref

11. M. Rosenberg, A. Kuznetsov, and A. Frorip, “Threshold-like dependences in albuminuria/proteinuria,” Eesti Arst (Estonian Doctor) 92(Suppl. 2), 1-52 (2013).

12. A. Sünter, A. Kuznetsov, A. Frorip, V. Korsakov, and M. Rosenberg, “Optical methods, devise and statistics of determination of albumin and/or protein concentration in human urine,” Saratov Fall Meeting 2015, Biophotonics Internet Invited Lecture.

13. S. G. Guminetsky, O. R. Gauka, G. I. Kokoschuk, P. M. Grigorishin, and N. L. Kirsh, “Absorption spectra of the main organic components of human urine in the absence of proteins,” Proc. SPIE 3904, 579 (1999).

14. K. Umimoto, Y. Kanaya, H. Kawanishi, and N. Kawai, “Measuring of uremic substances in dialysate by visible ultraviolet spectroscopy,” IFMBE Proc. 25(7), 42-45 (2009).

15. H.A. Schwertner, “Isolation and chromatographic analysis of unidentified fluorescence in biological fluids of patients with chronic renal disease,” Nephron 31(3), 209-211 (1982). Crossref

16. A. Kuznetsov, A. Frorip, A. Maiste, M. Ots-Rosenberg, and A. Sünter, “Visible auto-fluorescence in biological fluids as biomarker of pathological processes and new monitoring tool,” J. Innov. Opt. Health Sci. 8(3), 1541003 (2015).

17. PD-10 Desalting Columns (GE Healthcare), Instructions 52-1308-00 BB, General Electric Company, September 2007.

18. G. Konoplev et al., “Dual-wavelength optical sensor for on-line monitoring of uric acid concentration in spent dialysate during hemodialysis,” XI Baltic Nephrology Conference (Tartu), Programme and Abstract Book 48, 20-22 September 2012.

19. Y. Zuo, C. Wang, J. Zho, A. Sachdeva, and V. C. Ruelos, “Simultaneous Determination of Creatinine and Uric Acid in Human Urine by High-Performance Liquid Chromatography,” Analytical Sciences 24(12), 1589-1592 (2008). Crossref

20. Y. Yue-dong, “Simultaneous determination of creatine, uric acid, creatinine and hippuric acid in urine by high performance liquid chromatography,” Biomedical Chromatography 12(2), 47-49 (1998). 3.0.CO;2-Y target='_blank'>Crossref

21. Urine Anlyzer H-50.

22. E. V. Lerma, T. Desai, and P. Jawa, “Proteinuria: Background, Pathophysiology, Etiology,” 10 December 2015.

23. Reference < 200 g/g for protein/creatinine is being issued in the routine praxis of the TUHL.

24. Extinction Coefficients, A guide to understanding extinction coefficients, with emphasis on spectrophotometric determination of protein concentration, Pierce Biotechnology, October 2002.

25. S. C. Gill, and P. H. von Hippel, “Calculation of Protein Extinction Coefficients from Amino Acid Sequence Data,” Anal. Biochem. 182(2), 319-326 (1989). Crossref

26. D. C. J. Rhodes, “Binding of Tamm-Horsfall protein to complement 1q measured by ELISA and resonant mirror biosensor techniques under various ionic-strength conditions,” Immunology and Cell Biology 78(5), 474-482 (2000). Crossref

27. SIGMA ProductInformation.

28. I. Björk, F. A. Karlsson, and I. Berggård, “Independant Folding of the Variable and Constant Halves of a Lambda Immuniglobulin Light Chain,” Proc. Nat. Acad. Sci. 68(8), 1707-1710 (1971).

29. B. L. Boyanton, and K. E. Blick, “Stability Studies of Twenty-Four Analytes in Human Plasma and Serum,” Clin. Chem. 48(12), 2242-2247 (2002).

30. A. Kuznetsov, A. Frorip, M. Rosenberg, and N. Mulina, “Time dependences of concentrations of serum creatinine and uric acid in spent dialysate,” X1 Baltic Nephrology Conference (Tartu), Programme and Abstract Book 51, 20-22 September 2012.

31. C. Y. Yang, F. A. Chen, C. F. Chen, W. S. Liu, C. J. Shih, S. M. Ou, W. C. Yang. C. C. Lin, and A. H. Yang, “Diagnostic Accuracy of Urine Protein/Creatinine Ratio Is Influenced by Urine Concentration,” PLoS One 10(9), e0137460 (2015).

© 2014-2017 Samara National Research University. All Rights Reserved.
Public Media Certificate (RUS). 12+