[Amoniuria, urinary gap and osmolal in patients with moderate renal insufficiency]. / Amoniuria, gap urinario y osmolal en pacientes con insuficiencia renal moderada.

The chronic metabolic acidosis induces increase in the urinary ammonium production (NH4+u) like equalizer, reflected in major or measured minor, if the process is chronic or acute. The objective of the present work was to study the capacity of urinary acidification in patients with Failure Renal Chronic (FRC), stage II and III measuring NH4+u and to compare results with GAP urinary (GAPu), GAP urinary modified (GAPu mod), GAP Osmolal (GAPosm) and GAP Osmolal modified (GAPosm modif.) like indirect indices of amoniuria. Samples Venous/arterial blood and a draft fresh urine of 34 patients were analyzed. Statistically significant correlation was obtained (p < 0,003) between NH4+u ug/min/1.73m2 versus GAPu mmol/l (r = -0,4979) and GAPu mod mmol/l (- 0.5032), improving when NH4+u normatizó by creatinine (r = - 0.6793 and 0.6087 respectively, p < 0,0001). The GAPosm and GAPosm modif did not show significance at the time of evaluating NH4+u, contrary GAPu and GAPu mod would offer an indirect measurement of excretion of NH4+u, having given this last protein nutritional information. A value of p < 0.05 was considered statistically significant.

Detoxification in relation to toxin tolerance in desert woodrats eating creosote bush.

We studied the relationship between the use of three detoxification pathways and urine pH and the tolerance of desert woodrats from two populations to a mixture of naturally occurring plant secondary metabolites (mostly phenolics) in resin from creosote bush (Larrea tridentata). The two populations of desert woodrats came from the Mojave desert (Mojave woodrats), where woodrats consume creosote bush, and from the Great Basin desert (Great Basin woodrats), where the plant species is absent. We fed woodrats alfalfa pellets containing increasing levels of the phenolic resin and measured three detoxification pathways and urine pH that are related to detoxification of allelochemicals. We found that the excretion rate of two phase II detoxification conjugates, glucuronides and sulfides. increased with increasing resin intake, whereas excretion of hippuric acid was independent of resin intake, although it differed between populations. Urine pH declined with increasing resin ingestion. The molar proportion of glucuronides in urine was three times that of the other conjugates combined. Based on an evaluation of variation in the three detoxification pathways and urine pH in relation to resin intake, we rejected the hypotheses that woodrats' tolerance to resin intake is related to capacity for amination, sulfation, or pH regulation. However, Mojave woodrats had higher maximum glucuronide excretion rates, and we accepted the hypothesis that within and between populations woodrats tolerate more resin because they have a greater capacity for glucuronide excretion.

Direct enzymatic assay of urinary sulfated bile acids to replace serum bilirubin testing for selective screening of neonatal cholestasis.

Direct enzymatic assay of urinary sulfated bile acids is a sensitive, rapid, minimally invasive, and convenient method of detecting cholestasis in young infants. It may replace measurement of serum direct bilirubin for selective screening for biliary atresia and neonatal hepatitis syndrome at 1 month of age.

Fate in humans of dietary intake of cyanogenic glycosides from roots of sweet cassava consumed in Cuba.

We studied if consumption of boiled fresh roots from sweet cassava varieties grown in Cuba resulted in exposure to cyanogenic glycosides and their final breakdown product, cyanide. When adult, nonsmoking subjects consumed 1-4 kg cassava over 2 days, their urinary levels of the main cyanide metabolite, thiocyanate, only increased from a mean +/- SEM of 12 +/- 2 to 22 +/- 2 mumol/l, indicating a negligible cyanide exposure. Their mean urinary linamarin, the main cyanogenic glucoside in cassava, increased from 2 +/- 1 to 68 +/- 16 mumol/l. In a second experiment 5 subjects consumed one meal of 0.5 kg boiled cassava that contained 105 mumol linamarin and 8 mumol hydrogen cyanide (HCN). Quantitative urine collections prior to and after intake showed that 28% of linamarin was excreted during the following 24 hours, whereas a modest increase of urinary thiocyanate (SCN) only corresponded to the small amount of free HCN ingested. These results indicate that the dominant cyanogen in boiled cassava is glycosides that pass through the human body without causing cyanide exposure. It remains to be studied whether humans occasionally possess intestinal or tissue beta-glucosidases that can hydrolyse cyanogenic glycosides from cassava.

Increased fractional excretion of sulphate in stone formers.

This study was performed to determine urinary sulphate excretion in patients with renal stone disease. Stone formers showed a significantly higher fractional excretion of sulphate than control subjects; 80% of stone formers had fractional excretions > 0.26. No significant relationship was established between increased urinary sulphate excretion and any identifiable metabolic disorder, or the recurrence rate of stone episodes. The increase in fractional excretion of sulphate appears to be a more prevalent tubular defect among stone formers than has hitherto been reported.

Relative importance of urinary sulfate and net acid excretion as determinants of calciuria in normal subjects

In normal subjects fed western-mixed diets, in the fasting state, 39.6% of the variance of calciuria is accounted for by net acid excretion and 4% by sulfaturia. In the postprandial period, net acid accounts for 6.9% and sulfaturia for 11.8% of the variance of calciuria. As expected, after a load of ammonium chloride, net acid excretion exceeded the importance of sulfaturia (36.2% vs. 8.4%) and the opposite was observed after DL-methionine load (1.5% and 46.2%). A group of normal subjects fed vegetarian diets was also investigated. The excretion of the three variables measured were significantly reduced in this group when compared with that of the former group. In the fasting state the variance of calciuria was accounted mainly by net acid excretion (85.7%). In the postprandial state net acid (4.9%) and sulfate (2.2%) had much less importance as determinants of calciuria. It is concluded that in spite of their metabolic relationship, net acid and sulfate excretions are independent determinants of calciuria. The relative importance of each variable changes as a function of metabolic circumstances (Au)

Relative importance of urinary sulfate and net acid excretion as determinants of calciuria in normal subjects

In normal subjects fed western-mixed diets, in the fasting state, 39.6% of the variance of calciuria is accounted for by net acid excretion and 4% by sulfaturia. In the postprandial period, net acid accounts for 6.9% and sulfaturia for 11.8% of the variance of calciuria. As expected, after a load of ammonium chloride, net acid excretion exceeded the importance of sulfaturia (36.2% vs. 8.4%) and the opposite was observed after DL-methionine load (1.5% and 46.2%). A group of normal subjects fed vegetarian diets was also investigated. The excretion of the three variables measured were significantly reduced in this group when compared with that of the former group. In the fasting state the variance of calciuria was accounted mainly by net acid excretion (85.7%). In the postprandial state net acid (4.9%) and sulfate (2.2%) had much less importance as determinants of calciuria. It is concluded that in spite of their metabolic relationship, net acid and sulfate excretions are independent determinants of calciuria. The relative importance of each variable changes as a function of metabolic circumstances

Relative importance of urinary sulfate and net acid excretion as determinants of calciuria in normal subjects.

In normal subjects fed western-mixed diets, in the fasting state, 39.6% of the variance of calciuria is accounted for by net acid excretion and 4% by sulfaturia. In the postprandial period, net acid accounts for 6.9% and sulfaturia for 11.8% of the variance of calciuria. As expected, after a load of ammonium chloride, net acid excretion exceeded the importance of sulfaturia (36.2% vs. 8.4%) and the opposite was observed after DL-methionine load (1.5% and 46.2%). A group of normal subjects fed vegetarian diets was also investigated. The excretion of the three variables measured were significantly reduced in this group when compared with that of the former group. In the fasting state the variance of calciuria was accounted mainly by net acid excretion (85.7%). In the postprandial state net acid (4.9%) and sulfate (2.2%) had much less importance as determinants of calciuria. It is concluded that in spite of their metabolic relationship, net acid and sulfate excretions are independent determinants of calciuria. The relative importance of each variable changes as a function of metabolic circumstances.

Increased urinary excretion of inorganic sulfate in premature infants fed bovine milk protein.

We report measurements of urinary inorganic sulfate (iSO4) in 38 very low birth weight (VLBW) premature infants receiving various protein intakes in the first 2 months of life. The primary source of urinary iSO4 is the metabolism of amino acids containing sulfur (methionine, cysteine, taurine). It was hypothesized that urinary iSO4 excretion would be increased in VLBW infants fed the relatively high concentrations of protein in mother's own milk (HM), mother's own milk fortified with 0.85 gm/dl bovine whey (fortified HM), and a special formula for premature infants (Similac Special Care, 20 cal/oz), and that urinary iSO4 excretion would correlate with calcium excretion. VLBW premature infants fed HM (protein intake 3.3 gm/kg day) excreted very small amounts of urinary iSO4 compared with infants fed fortified HM (4.5 gm/kg/day protein), Similac SC (2.9 gm/kg/day protein), or Similac (2.7 gm/kg/day protein), all three of which contain bovine whey. Unlike the case in adults, there was no correlation between either total protein intake and urinary calcium excretion or urinary iSO4 excretion. There was, however, a significant correlation between methionine intake and urinary iSO4 excretion (r = 0.48). We speculate that increased urinary iSO4 excretion is indicative of an overload of sulfur-containing amino acids, namely methionine, present in bovine whey protein. The data also support the ability of premature infants to catabolize relatively large quantities of sulfur-containing amino acids after 2 weeks of age.

Favorece la Giardia lamblia la proliferación intestinal de bacterias? / Does giardia lamblia favor intestinal bacterial proliferation?

Con el propósito de estudiar si la G. lamblia se acompaña en el intestino de una gran población de bacterias productoras de indol, se investigó la concentración de sulfato de indoxil en la orina, antes y después de erradicar este parásito. Los resultados plantean, indirectamente, que la giardiasis se asocia a una proliferación de enterobacterias que sobrepasa en magnitud la que ordinariamente existe en el intestino