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Drug testing, commonly used in health care, workplace, and criminal settings, has become widespread during the past decade. Urine drug screens have been the most common method for analysis because [...]

Smoking, diet, and physical activity may impact chronic diseases in part by promoting or attenuating oxidative stress. We evaluated associations between lifestyle factors and urine [F.sub.2a]-isoprostanes, a marker of oxidative stress in 1610 participants of the Study of Women's Health Across the Nation (SWAN). Dietary intake and physical activity were assessed at baseline and the 5th year 05 (Y05). These data were related to Y05 urinary [F.sub.2a]-isoprostane concentration with regression analyses. Median urine [F.sub.2a]-isoprostane concentration was 433 ng/L overall, 917 ng/L in smokers [inter-quartile range (IQR): 467, 1832 ng/L], and 403 ng/L in nonsmokers (IQR: 228, 709 ng/L; P< 0.0001 for difference). Higher trans fat intake was associated with higher urine [F.sub.2a]-isoprostane concentration; partial Spearman correlations ([[rho].sub.x|y]) between Y05 urine [F.sub.2a]-isoprostane concentration and trans fatty acids was O. 19 (P = 0.03) in smokers and O. 13 (P < 0.0001) in nonsmokers. Increased log trans fat intake from baseline to Y05 was associated with higher concentration of log urine [F.sub.2a]- isoprostanes in nonsmokers ([beta] = 0.131, SE = 0.04, P = 0.0003). In nonsmokers, the partial correlation ([[rho].sub.x|y]) between lutein and urine [F.sub.2a]-isoprostane concentration was -0.13 (P < 0.0001). Increased intake of log lutein from baseline to Y05 was also associated with lower log urine [F.sub.2a]-isoprostane concentration ([beta] = -0.096, SE = 0.03, P = 0.0005) in nonsmokers. Increased zinc intake from baseline to Y05 was associated with lower log urine [F.sub.2a]-isoprostane concentration in smokers and nonsmokers ([beta] = -0.346, SE = 0.14, P- 0.01), and 0.117, 0.04 (P = 0.001), respectively]. In conclusion, diet (fat subtypes, zinc, and vegetable components) and smoking were associated with urine [F.sub.2a]-isoprostanes, a marker of oxidative stress.

Intake urinalysis test result (drug positive vs. negative) has been previously identified as a strong predictor of drug abuse treatment outcome, but there is little information about how this prognostic factor may interact with the type of treatment delivered. The authors used data from a multisite study of abstinence incentives for stimulant abusers enrolled in outpatient counseling treatment (N. M. Petry, J. M. Peirce, et al., 2005) to examine this question. The first study urine was used to stratify participants into stimulant negative (n = 306) versus positive (n = 108) subgroups. Abstinence incentives significantly improved retention in those testing negative but not in those testing positive. Findings suggest that stimulant abusers presenting to treatment with a stimulant-negative urine benefit from abstinence incentives, but alternative treatment approaches are needed for those who test stimulant positive at intake. Keywords: drug abuse treatment, stimulants, abstinence incentives, contingency management, intake urine test results

Stereoisomeric identification of norephedrine (NE) derived from methamphetamine (MA) or amphetamine (AM) was investigated by SIM-GC/MS assay using the urine of 33 MA abusers and 1 AM abuser. The assay simultaneously identified TFA-derivatized MA and AM metabolites, including AM, p-hydroxyl-MA (p-HMA), and p-hydroxyl-AM (p-HAM). The analysis lasted ~43 min, with a signal-to-noise ratio of [greater than or equal to] 3 and a detection limit of 50 ng/mL. Among 12 urine samples from different subjects, only the S (+) form of MA and its metabolites (AM, p-HMA, p-HAM) was detected, however, a (1R,2S)-(-)-NE stereoisomer was also identified. Among the urine samples of two subjects, only the R (-) form of MA and its metabolites (AM, p-HMA, p-HAM) was detected, while NE was not detected. Following urinalysis of urine obtained from 19 MA abusers and 1 AM abuser, only the (1R,2S)-(-)NE stereoisomer was identified, while unmetabolized MA, AM, and their metabolites (p-HMA, p-HAM), showed stereoselective metabolism. Although (1R,2S)-(-)-ephedrine (EP) alone was found in the urine of 1 (S)-(+)-MA user and 1 (S)-(+)- and (R)-(-)-MA user among 33 MA users, it was not present in the urine of the remaining 31 subjects. Therefore, (1R,2S)-(-)-NE was likely not of (1R,2S)-(-)-EP origin and was most likely from (S)-(+)AM of the MA metabolite. The production ratio of (1R,2S)(-)-NE to (S)-(+)-AM ranged from 0.01 to 0.25 in MA abusers and was 0.12 in AM abusers.

A highly sensitive enzyme-linked immunosorbent assay (ELISA) has been developed for tetrahydrogestrinone (THG), the new designer anabolic steroid responsible for the well-known Balco scandal announced in year 2003. Antibodies have been raised against 18a-homo-pregna-4,9, 11-trien-17[beta]-ol-3-carboxymethyl oxime coupled to horseshoe crab hemocyanin. The hapten has been synthesized from gestrinone by controlled reduction of the triple bond of the ethinyl group at position C-17, without affecting the double bonds of the steroidal rings, followed by reaction of the keto group at C-3 with (carboxymethoxy)-amine hemihydrochloride to form the oxime bond. The antisera obtained has been used in combination with 18a-homo-pregna-4,9,11-trien-17[beta]-ol-20-yn-3-carboxymethyl oxime, a hapten derivative of gestrinone, coupled to bovine serum albumin to establish a competitive ELISA. Under the conditions used, THG can be detected in buffer with a limit of detection (LOD) of 0.045 [+ or -] 0.015 [micro]g L-1 (N = 9). The assay is very selective since other steroids assessed are not recognized. Preliminary experiments performed with human urine samples demonstrate that the assay can be applied to the analysis of these samples after a simple sample treatment method reaching a LOD of 0.25 [+ or -] 0.14 [micro]g [L.sup.-1]. Accuracy is very good as demonstrated by the excellent correlation obtained when analyzing blind spiked urine samples (slope 0.93, [R.sup.2] = 0.992).

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.03.012 Byline: Melanie E. Bennett, Alan S. Bellack, Jean S. Gearon Keywords: Substance abuse; Severe mental illness; Assessment Abstract: This paper provides a description of The Substance Use Event Survey for Severe Mental Illness (SUESS), a brief (20-30 min) interview that assesses clinical issues and domains that are relevant patients with substance use disorders and severe mental illness. First, we discuss the need for a new clinical measure for dual diagnosis patients, as well as our process of creating domains and items and developing the content of the assessment. Second, we provide a first look at the performance of the SUESS in a large sample of dually diagnosed patients from several large scale studies, including how patients responded to the instrument and their ability to complete the items. Third, we present initial reliability data on the SUESS. Finally, we include some initial validity data, including comparison of the self-report of substance use questions to urinalysis results, and verification of the service use information from medical record review. The SUESS appears to be a useful assessment that is tolerated and understood by dual diagnosis patients, and shows good preliminary reliability and validity. Author Affiliation: Department of Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, Suite 551, Baltimore, Maryland, 21201, United States VA Capital Network Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, Maryland, United States

Human urine contributes 80% of the total nitrogen and 40-50% of the total phosphate load to municipal wastewater. This study examines the impact of separate urine collection and treatment on wastewater treatment. An integrated wastewater and urine treatment process was defined, in which single high-rate ammonium removal over nitrite and anaerobic ammonium oxidation processes and struvite recovery are at the heart of the nutrient management. The model study demonstrated that if 50% or more of urine were collected and treated separately, integrated wastewater treatment with more compact and energy-efficient processes would be possible. The integrated wastewater and urine treatment is compared to an existing state-of-the-art treatment process. The main advantage of urine separation is not only a better effluent quality. Existing processes including tertiary treatment can already produce very good effluent quality with total effluent nitrogen and phosphate concentrations of 2.5 and 0.5 g/[m.sup.3], respectively. The main advantage of urine separation is the production of this same good effluent quality with a remarkable saving in resources. With sufficient urine separation, generation of net primary energy is possible. DOI: 10.1061/(ASCE)0733-9372(2006)132:3(331) CE Database subject headings: Wastewater management; Nitrogen; Municipal wastes; Nutrients.

Abstract The purpose of this study was to describe the reproducibility of timed-urine collections for renal clearance studies and the effect variations in urine collection has on measurement of glomerular [...]

Abstract Nitric oxide (NO) is an important messenger molecule with a wide range of actions in virtually all cell systems and organs. In kidneys it participates in glomerular and medullary [...]

Measured trends in drug use can potentially reflect changes in drug use, changes in the accuracy of the measurement instrument, or both. This paper compares marijuana use trends from 1987 to 2001 using self-report and urinalysis data from arrestees interviewed at 23 sites served by the Arrestee Drug Abuse Monitoring (ADAM) Program. Overall, 60% of the variation in reported use reflected changes in detected use. Most notably, reported and detected use suggested different dynamics to the increase in marijuana use during the 1990s. The growth in detected use started later, increased more, and lasted longer. Several factors appear to have clearly contributed to this divergence between the measures: the percentage of marijuana users that disclosed their activity changed over time, the accuracy of ADAM's urinalysis test increased with time, and the percentage of infrequent users changed over time (urinalysis tests are less likely to detect infrequent users). The paper concludes with recommendations for the careful analysis of marijuana use trends using self-report data, biological data, or both. Trends in cocaine, crack, heroin, and methamphetamine are also considered.

Abstract A total of 1,044 school children identified with hematuria and/or proteinuria during a mass school urine screening test were referred to pediatric nephrologists at 13 hospitals in Korea. These [...]

Byline: Anna M. Wasilewska (1), Walentyna M. Zoch-Zwierz (1) Keywords: Transforming growth factor-[beta]1; Nephrotic syndrome; Cyclosporin; Urine Abstract: The aim of the study was to assess urinary transforming growth factor (TGF)-[beta]1 in children with steroid-dependent nephrotic syndrome (SDNS) treated with cyclosporine A (CyA) and ACE inhibitors (ACEI). The study involved 24 children (14 boys and 10 girls) with SDNS and signs of focal segmental glomerulosclerosis. The children were treated with prednisone, CyA, and ACEI. All children were examined four times: A during relapse of proteinuria, before treatment with CyA and ACEI, and B after 3 months, C 6 months, and D 12 months of treatment. The control group consisted of 20 healthy children of the same age. The urinary TGF-[beta]1 level was determined by ELISA (R and D Quantikine). The serum CyA level was measured by monoclonal antibody fluorescence polarization immunoassay. Prior to CyA treatment, the urinary TGF-[beta]1 level was the highest (135.61+-38.31 pg/mg creatinine). During CyA treatment, TGF-[beta]1 was reduced to 117.96+-81.57 after 3 months, to 80.26+-49.52 after 6 months, and to 44.00+-31.83 pg/mg creatinine after 12 months, but it was still higher than in the control group. At 3 months there was a positive linear correlation between urinary TGF-[beta]1 and proteinuria ( r =0.654, P &lt 0.01). These results indicate that the urinary TGF-[beta]1 level increases in proportion to proteinuria during relapse of NS. Treatment with CyA and ACEI also influences urinary TGF-[beta]1, which is still higher after 12 months of treatment than in healthy children. Author Affiliation: (1) 1st Department of Pediatrics, Medical University in BiaAystok, 17 Waszyngtona Street, 15--274 BiaAystok, Poland Article History: Registration Date: 23/07/2004 Received Date: 13/04/2004 Accepted Date: 06/07/2004 Online Date: 13/10/2004

Byline: Kazunari Kaneko (1), Mutsumi Murakami (2), Kazumi Shiraishi (3), Masaru Matsumoto (3), Kuniaki Yamauchi (3), Teruo Kitagawa (3), Yuichiro Yamashiro (4) Keywords: Urinary screening; Automated urinary flow cytometer; Glomerular hematuria Abstract: We aimed to assess the utility of a newly developed automated urinary flow cytometer (UFCM) in differentiating the origin of hematuria in the mass screening system for renal diseases in school children. In total, 4,620 children aged 6--14 years with abnormal urinary findings by the screening program in Tokyo were enrolled. Tentative diagnoses were made based on the criteria for this screening program: nephritis in 11, suspected nephritis in 104, hematuria in 771, minimal hematuria in 1,506, proteinuria in 477, urinary tract infection in 83, and healthy in 1,668. Glomerular hematuria, assessed by UFCM, was found in 81.8% of nephritis, 58.7% of suspected nephritis, 59.7% of hematuria, 57.4% of minimal hematuria, 13.4% of proteinuria, and 21.5% of the healthy group. The presence of glomerular hematuria assessed by UFCM had a sensitivity of 61.0%, specificity of 78.5%, positive predictive value of 16.3%, and negative predictive value of 96.7% for the diagnosis of nephritis and suspected nephritis. Thus, our results imply that the absence of glomerular hematuria as assessed by UFCM is highly predictive of the absence of nephritis. If "healthy" children with non-glomerular hematuria by UFCM could be excluded, the total annual cost saving would be approximately 147.4 million JPY, which is equivalent to 5.2% of the current system. In conclusion, a simple, automated and rapid test for glomerular hematuria using UFCM is useful for mass screening. It can precisely predict children with only transient hematuria who do not have any serious illness, and therefore can exclude further unnecessary examinations, resulting in the improvement of cost-effectiveness of the current program. Author Affiliation: (1) Department of Pediatrics, Juntendo University Urayasu Hospital, 2-l-l Tomioka, Urayasu-shi, Chiba 279--0021, Japan (2) Department of Pediatrics, Nippon Medical School Hospital, Tokyo, Japan (3) Tokyo Health Service Association, Tokyo, Japan (4) Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan Article History: Registration Date: 19/02/2004 Received Date: 24/09/2003 Accepted Date: 03/02/2004 Online Date: 12/03/2004

Byline: A. C. P. Cillo (1), H. Cattini (2), M. A. Boim (3), N. Schor (3) Keywords: Keywords Urinary excretion; Calcium; Uric acid; Oxalate; Citrate; Creatinine; Renal stones; Newborn Abstract: The determination of urinary excretion of lithogenic elements in healthy newborns involves factors ranging from urine collection and data handling to maternal influences, which can cause difficulties in analyzing the results. The objective of this study was to determine normal values of parameters related to lithogenesis, such as calcium, uric acid, citrate, and oxalate, in urine of healthy newborns using isolated samples, focusing on variations according to gender, weight, milk ingestion, and family history of lithiasis. Parameters measured in isolated urine samples from 104 healthy newborns (77 males and 27 females) were corrected by creatinine. The ratios were expressed as milligram/milligram of creatinine: calcium/creatinine of 0.10+-0.01 (X+-SE), uric acid/ creatinine of 1.10+-0.10, citrate/creatinine of 0.56+-0.04, and oxalate/creatinine of 0.07+-0.01. Differences were observed between males and females, in terms of uric acid (0.80+-0.07 vs. 1.10+-0.10 mg/mg, P&lt 0.05), citrate (0.05+-0.06 vs. 0.17+-0.05, P&lt 0.05), sodium (0.17+- 0.01 vs. 0.05+-0.01, P&lt 0.001), and potassium (0.05+- 0.01 vs. 0.20+-0.02, P&lt 0.001). Interestingly, the urinary concentration of protector factors such citrate and potassium was higher in females than in males with low sodium excretion. Artificial milk feeding leads to higher calcium (0.10+-0.06 vs. 0.06+-0.01), uric acid (1.40+-0.20 vs. 0.90+-0.09, P&lt 0.05), citrate (0.90+-0.09 vs. 0.50+-0.04, P&lt 0.001), and oxalate (0.17+-0.03 vs. 0.05+-0.01, P&lt 0.001) excretion when compared with breast feeding. There was higher excretion of calcium and sodium in patients under 3 kg. Children with familial antecedents presented some differences in urinary excretion, with higher uric acid (1.50+-0.30 vs. 0.80+-0.08, P&lt 0.05) but lower calcium (0.05+-0.02 vs. 0.10+-0.01, P&lt 0.05) and sodium (0.15+-0.02 vs. 0.20+-0.02, P&lt 0.05) excretion, respectively. This report provides urinary parameters obtained in healthy newborns and correlates them with factors that could be involved in the genesis of osteopenia, renal stones, and/or nephrocalcinosis. Author Affiliation: (1) Department of Pediatrics, Division of Nephrology, Pontificia Universidade Catolica de Campinas, Campinas, Brazil, BR (2) Department of Pediatric Nephrology, Hospital e Maternidade S. Joana, Sao Paulo, Brazil, BR (3) Division of Nephrology, Universidade Federal, Sao Paulo, Brazil, BR (4) Rua Botucatu, 740, Sao Paulo, Brazil, CEP 04023-900. Nestor@nefro.epm.br, BR Article note: Received: 8 May 2000 / Revised: 7 June 2001 / Accepted: 12 June 2001

Byline: Vimal Chadha (1), Uttam Garg (2), U. S. Alon (1) Keywords: KeywordsaUrine; Osmolality; Specific gravity; Refractometry; Urinometer; Reagent strips Abstract: The measurement of urine concentration provides information concerning the kidney&apos;s ability to appropriately respond to variations in fluid homeostasis. It also assists in the interpretation of other tests performed on the same urine specimen. The gold standard of estimating urinary concentration is the measurement of its osmolality however, this procedure is not readily available to the practicing physician. Therefore, urine concentration is usually determined by measurement of its specific gravity (SG), which provides a fair estimate of urine osmolality. Over the years numerous tests have been developed to measure urine SG in a simple, quick, reliable and easily available method. These tests measure SG either directly (e.g., gravimetry) or by indirect methods (e.g., refractometry and reagent strip). All these tests have certain limitations based on their underlying physical principles. Specific gravity as measured by refractometry is influenced by proteinuria, such that for each 10 g/l protein the SG increases by 0.003. SG is also influenced by glucosuria such that it increases by approximately 0.002 per 10 g/l glucose when compared with urinary osmolality. Unlike osmolality, which is only affected by the number of particles, refractometry is affected by number, mass and chemical structure of the dissolved particles hence large molecules like radiographic contrast or mannitol will increase SG relative to osmolality. The reagent strip is minimally affected by glucose, mannitol or radiographic contrast. However, it is affected by urinary pH such that only urine in the pH range of 7.0--7.5 can be correctly interpreted. The measurement of SG by reagent strip is based on the ionic strength of the urine and thus is significantly affected by the ionic composition of the urine and by proteins which have an electric charge in solution. In our experience, SG measured by the refractometer is consistently more accurate than the reagent strip. For the clinician who is interpreting urine SG results, it is important to be aware of these limitations and understand the reasons for possible potential errors of each particular method. Author Affiliation: (1) Section of Pediatric Nephrology, The Children&apos;s Mercy Hospital, University of Missouri at Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA e-mail: ualon@cmh.edu Tel.: +1-816-2343010, Fax: +1-816-2343494, US (2) Section of Pathology and Laboratory Medicine, The Children&apos;s Mercy Hospital, University of Missouri at Kansas City, Kansas City, Missouri, USA, US Article note: Received: 14 August 2000 / Revised: 24 November 2000 / Accepted: 27 November 2000

Byline: C.-Y. Lin (1), Chia-Chang Hsieh (1), Wei-Perng Chen (1), Ling-Yoeu Yang (1), Hsin-Hui Wang (1) Keywords: KeywordsaMass urinary screening; Proteinuria; Hypertension; Chronic renal insufficiency; Systemic lupus erythematosus Abstract: To date, the underlying diseases and follow-up of Taiwanese children screened by urinalysis have not been reported. The grading of urine abnormalities varied from grade A (microscopic hematuria only), grade B (light proteinuria only), grade C (light proteinuria and microscopic hematuria) to grade D (heavy proteinuria). From January 1991 to August 1998, 630 students, aged 6--15 years and with positive urinary screening, were admitted to our hospital for further evaluation. Of these, 573 students had confirmed abnormal findings, 298 were boys, 275 were girls, and 294 students received a renal biopsy and have had regular follow-up visits. This study was designed to retrospectively elucidate: (1) the relationship between grading of urine abnormality and underlying disease (2) the relationships among hypertension, grading of urine abnormality, and underlying disease (3) the underlying disease of low serum C3 level and (4) to determine whether urinary screening progressively decreased the number of students with end-stage renal disease (ESRD) annually. The results show that glomerular nephritis (GN) is still one of the major causes of urinary abnormalities. The most-important secondary GN was systemic lupus erythematosus (SLE) with lupus nephritis. One-quarter of the patients fulfilled at least four of the revised American Rheumatology Association (ARA) criteria for SLE at first administration, while the others who fulfilled only two to three of the revised ARA criteria had gradually developing signs and symptoms of SLE at follow-up. The percentage of SLE patients amongst anti-nuclear antibody (ANA) positive children was 72%. Membranoproliferative GN is very rare. The distribution of hypertension was 8.2% in grade A, 10.7% in grade B, 9.7% in grade C, and 28.9% in grade D urinary abnormality. There were statistical differences between grade D and either grade A or B or C (P&lt 0.05). Lower serum C3 levels were found only in a minority of patients, including those with SLE. In this series, focal segmental glomerular sclerosis (FSGS) and active class IV lupus nephritis patients were found early enough to receive methylprednisolone pulse plus cyclosporine A therapy. To date there have been only 2 cases (5%) of FSGS with impaired renal function, and none of the lupus nephritis patients are in the predialysis stage. In conclusion, GN is still the major cause of urinary screening abnormality. ANA study is indicated in all Chinese students with abnormal urinary screening. The correlations between the severity of proteinuria and hypertension showed more-severe proteinuria in patients with nephritis as well as in those with hypertension. Author Affiliation: (1) Department of Pediatrics, Taipei Veterans General Hospital, Shih-Pai, Taipei, Taiwan, 11217, Republic of China e-mail: cylin2@vghtpe.gov.tw Tel.: +886-2-2875-7140, Fax: +886-2-2873-9019, TW (2) National Yang-Ming University, Taipei, Taiwan, Republic of China, TW Article note: Received: 4 October 1999 / Revised: 13 July 2000 / Accepted: 1 November 2000

Byline: Hyun Soo Kim (1), Hae Won Cheon (1), Jeong-Hoon Choe (1), K. H. Yoo (1), Young Sook Hong (1), Joo Won Lee (1), Soon Kyum Kim (1) Keywords: KeywordsaProteinuria; Osmolality; Ratio; Children Abstract: A prospective study was conducted to determine the correlation of early morning urinary protein/osmolality ratio (mg/l/mosmol/kg) with 24-h urinary protein excretion (mg/m.sup.2/day). Study patients consisted of 53 children (aged 1 month to 15 years). Early morning urine samples and 24-h urine samples were collected and analyzed. In group 1 (children without proteinuria), early morning urinary protein/creatinine ratio (Uprot/Ucr, mg/mg) was 0.061+-0.011 and the protein/osmolality ratio (Uprot/Uosm, mg/l/mosmol/kg) was 0.073+-0.014. Twenty-four hour urinary protein excretion in group 1 had no significant correlation with Uprot/Ucr or Uprot/Uosm. In group II (children with proteinuria), Uprot/Ucr was 5.78+-1.10 and Uprot/Uosm was 4.42+-1.34. Twenty- four hour urinary protein excretion in group 2 was 1483.6+-303.7 mg/m.sup.2/day and its correlation with both Uprot/Uosm and Uprot/Ucr was highly significant (r= 0.87, P&lt 0.001 and r=0.88, P&lt 0.001, respectively). The accepted nephrotic level of proteinuria of 40 mg/m.sup.2/h coincides with a Uprot/Uosm ratio of 1.9. In conclusion, early morning urinary Uprot/Uosm is a simple and potentially useful test for 24-h urinary protein excretion, and possibly could be used safely for the assessment of the degree of proteinuria in children. Author Affiliation: (1) Department of Pediatrics, Korea University, Guro Hospital, 80 Guro-Dong, Guro-Gu, Seoul 152-703, Korea e-mail: guroped@chollian.net Tel.: +82-2-8186128, Fax: +82-2-8589396, KR Article note: Received: 13 April 1999 / Revised: 23 February 2000 / Accepted: 15 August 2000

Byline: F. Manz (1), Rainer Kehrt (1), Berthold Lausen (1), Anja Merkel (1) Keywords: Key wordsaUrinary calcium excretion; Hypercalciuria; Calcium intake; Age; Sex Abstract: Urinary calcium (Ca) excretion was determined in 1,578 24-h urine samples from 507 healthy children and adolescents (252 boys, 255 girls 2.8--18.4 years) participating in the DONALD Study and is presented for 32 different age and sex groups. Calciuria values related to body weight (mg/kg per day) were relatively constant except for a transient decrease during puberty in all centiles, with a later onset in boys than girls. Distribution of calciuria (mg/kg per day) was best normalized by log transformation, with an almost constant standard deviation of the log-transformed values. Ca excretion was aY=4 mg/kg per day in 8.6% and aY=6 mg/kg per day in 1.5% of the urine samples. Based on Ca excretion rates of 1,080 pairs of 24-h urine samples from 364 children and adolescents, sensitivity, specificity, and the predictive value for hypercalciuria (aY=4 mg/kg per day) in the next urine sample were calculated at three test levels classifying calciuria of the initial urine sample. In summary, this study presents normal values of urinary Ca excretion related to age and sex in a population of healthy German children and adolescents consuming a typical western-style diet. A high level of calciuria in a random urine sample is important in the diagnosis of hypercalciuria. Author Affiliation: (1) Research Institute of Child Nutrition, D-44225 Dortmund, Germany e-mail: manz@fke.uni-dortmund.de Fax: +49-231-711581, DE Article note: Received: 25 February 1997 / Revised: 28 April 1999 / Accepted: 3 May 1999

Byline: D. Muller (1), E. Sievers (1), P. Eggert (1) Keywords: Key wordsaN-Acetyl-[beta]-D-glucosaminidase; Insulin-dependent diabetes mellitus; Hyperfiltration Abstract: The measurement of urinary enzymes in patients with diabetes mellitus has become a useful additional test for the early detection of nephropathy. Controversy persists concerning methods of measurement since during early stages of insulin-dependent diabetes mellitus children develop the so-called hyperfiltration syndrome. This study was performed to determine whether elevated levels of excreted creatinine influence the determination of the enzyme N-acetyl-[beta]-D-glucosaminidase (NAG). Reference values for NAG in single-spot urines (units NAG/mmol creatinine) and in 24-h collections (units NAG/l urine) were established in two different groups of 105 and 111 healthy children. NAG was then measured in single-spot urines (as NAG/mmol creatinine) and in collection urines of 30 diabetic children within the same 24-h period and compared with the reference population. These results were compared with hemoglobin (Hb)A1.sub.a--c and fructosamine values as well as creatinine clearance of the diabetic patients. There was a direct correlation between the NAG levels in single-spot and 24-h urine collections of diabetic patients. However, the NAG/creatinine ratio in the single-spot urines did not correlate with the HbA1.sub.a--c or fructosamine level. When 24 h collections (expressed as NAG/l) were used, the results correlated well with HbA1.sub.a--c and fructosamine. There was an inverse correlation between the creatinine clearance and the NAG/creatinine ratio, i.e., a high creatinine clearance correlated with a low NAG/creatinine ratio. This was not the case for 24 h collections (expressed as units/l). Hence, in children with insulin-dependent diabetes mellitus 24-h urine collections should be used for urinanalysis. Parameters should not be related to creatinine, since the ratio of urinary protein and creatinine is unreliable because of the high urinary creatinine during the hyperfiltration state. Author Affiliation: (1) Children&apos;s Hospital, Christian Albrecht&apos;s University, Schwanenweg 20, Kiel, Germany, DE (2) University of Nijmegen, 162 Cell Physiology, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands e-mail: d.mueller@celfys.kun.nl Tel.: +31-24-3614211, Fax: +31-24-3540525, NL Article note: Received: 16 July 1998 / Revised: 22 September 1998 / Accepted: 23 September 1998